Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/51859.2574
S. P. Patel, D. Ramavataram, N. Chandrika, H. Lad
Introduction: Type 2 Diabetes Mellitus (T2DM), accounting for 85-90% of diabetic subjects globally, is reported to be also caused by imbalance between pro-oxidant and antioxidant factors. This very fact necessitates exploring and evaluating the possibilities of role of various antioxidant trace elements like selenium and zinc, in further understanding the pathogenesis and appropriate applicable intervention required, if any for patients suffering from diabetes mellitus. The levels of trace elements like selenium and zinc, representing antioxidant capacity, might be implicated in development of type II diabetes and vice versa. Aim: To evaluate the levels of serum selenium and zinc in critically ill type 2 diabetic patients and comparing them with healthy individuals. Materials and Methods: This case-control study was conducted for a period of nine months from October 2016 to June 2017. Fifty critically ill type 2 diabetic patients and 150 apparently healthy age and gender matched controls were recruited into this study. Serum selenium and zinc levels were estimated in subjects of both the groups. Mean, standard deviation, Analysis of Variance (ANOVA) test and student t-test were statistical tools used to interpret the results. Results: Fifty critically ill T2DM patients constituted the cases and 150 age and sex matched healthy adults were in the control group. Mean Random Blood Sugar (RBS) in controls was 113.14±25.52 mg/dL while in that in cases was 246.48±98 mg/dL and the difference was significant (p-value <0.01). This study showed significant difference (p<0.01) in the level of serum selenium and zinc levels in critically ill diabetic patients compared to healthy individuals across all age groups i.e., <40, 40 to 55 and >55 years. The mean level of selenium in cases and controls were 83.8±11.97 and 103.08±67.7 μg/dL (p-value <0.01) respectively. The mean level of zinc amongst cases and controls were 40.83±21.19 and 103.08±67.7 (p-value <0.01), respectively. Conclusion: Serum selenium and zinc levels were decreased in critically ill type 2 diabetic patients owing to the increased production of free radicals in them. Supplementation of selenium and zinc in these individuals could be beneficial and is therefore recommended.
{"title":"Levels of Serum Selenium and Zinc in Critically ill Type 2 Diabetics and Normal Healthy Individuals at Tertiary Care Hospital, Surat, India","authors":"S. P. Patel, D. Ramavataram, N. Chandrika, H. Lad","doi":"10.7860/njlm/2022/51859.2574","DOIUrl":"https://doi.org/10.7860/njlm/2022/51859.2574","url":null,"abstract":"Introduction: Type 2 Diabetes Mellitus (T2DM), accounting for 85-90% of diabetic subjects globally, is reported to be also caused by imbalance between pro-oxidant and antioxidant factors. This very fact necessitates exploring and evaluating the possibilities of role of various antioxidant trace elements like selenium and zinc, in further understanding the pathogenesis and appropriate applicable intervention required, if any for patients suffering from diabetes mellitus. The levels of trace elements like selenium and zinc, representing antioxidant capacity, might be implicated in development of type II diabetes and vice versa. Aim: To evaluate the levels of serum selenium and zinc in critically ill type 2 diabetic patients and comparing them with healthy individuals. Materials and Methods: This case-control study was conducted for a period of nine months from October 2016 to June 2017. Fifty critically ill type 2 diabetic patients and 150 apparently healthy age and gender matched controls were recruited into this study. Serum selenium and zinc levels were estimated in subjects of both the groups. Mean, standard deviation, Analysis of Variance (ANOVA) test and student t-test were statistical tools used to interpret the results. Results: Fifty critically ill T2DM patients constituted the cases and 150 age and sex matched healthy adults were in the control group. Mean Random Blood Sugar (RBS) in controls was 113.14±25.52 mg/dL while in that in cases was 246.48±98 mg/dL and the difference was significant (p-value <0.01). This study showed significant difference (p<0.01) in the level of serum selenium and zinc levels in critically ill diabetic patients compared to healthy individuals across all age groups i.e., <40, 40 to 55 and >55 years. The mean level of selenium in cases and controls were 83.8±11.97 and 103.08±67.7 μg/dL (p-value <0.01) respectively. The mean level of zinc amongst cases and controls were 40.83±21.19 and 103.08±67.7 (p-value <0.01), respectively. Conclusion: Serum selenium and zinc levels were decreased in critically ill type 2 diabetic patients owing to the increased production of free radicals in them. Supplementation of selenium and zinc in these individuals could be beneficial and is therefore recommended.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270275","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/2022/51870.2675
M. Modi, K. Nandi, V. Jain, Kailash Chandra
Introduction: Sodium fluoride mixed vacutainers were once viewed as the gold standard tubes for glucose analysis. However, their ineffectiveness in inhibiting glycolysis, especially in the first one to four hours has been reported in several studies. The accurate blood glucose estimation is crucial for the diagnosis and management of diabetes mellitus. Aim: To find out a cost effective and feasible alternative blood collection vacutainer for the estimation of accurate blood glucose. Materials and Methods: A cross-sectional study was conducted at the Blood Collection Centre of HAH Centenary Hospital, New Delhi, India, from December 2019 to July 2020. A blood sample was collected from 155 subjects in each-sodium fluoride [Na2EDTA], heparin [sodium heparin] and Serum Separator Tube (SST). To find out the glucose reduction during blood coagulation in SST tubes, the glucose levels (n=25) of sodium fluoride (plasma) at 0 hr and 30 mins after coagulation in SST tubes were compared. The remaining study subjects (n=130) were categorised into two groups (65 subjects in each group) and assessed for the reduction of glucose at 4°C and 25°C. Further, the reduction of glucose was also studied in both the groups as per glucose concentrations <100 mg/dL (n=25), 100-200 mg/dL (n=25) and >200 mg/dL (n=15) in each group. Results: The inter assay coefficient of variation of quality control samples of glucose (n=61) was 3.0%. The highest percentage of glucose reduction was found in the green vacutainers (p<0.05) at 4°C and 25°C storage temperatures. There was no significant reduction of glucose level in SST vacutainers at 4°C up to 96 hrs of analysis (p>0.05) and the result was comparable to grey vacutainers. Further, there was no haemolysis in the SST vacutainers up to 96 hrs of analysis, however, green and grey vacutainers showed enormous haemolysis. Conclusion: The glucose analysis in SST vacutainers can reduce the loss of sample, cost of analysis, and interferences in the analysis due to haemolysis. The study strongly suggests that all the analytical laboratories should do glucose analysis in SST vacutainers.
{"title":"A Comprehensive Stability Study of Glucose Concentrations Measured in Sodium Fluoride, Heparin and Serum Separator Tubes: A Cross-sectional Study","authors":"M. Modi, K. Nandi, V. Jain, Kailash Chandra","doi":"10.7860/njlm/2022/51870.2675","DOIUrl":"https://doi.org/10.7860/njlm/2022/51870.2675","url":null,"abstract":"Introduction: Sodium fluoride mixed vacutainers were once viewed as the gold standard tubes for glucose analysis. However, their ineffectiveness in inhibiting glycolysis, especially in the first one to four hours has been reported in several studies. The accurate blood glucose estimation is crucial for the diagnosis and management of diabetes mellitus. Aim: To find out a cost effective and feasible alternative blood collection vacutainer for the estimation of accurate blood glucose. Materials and Methods: A cross-sectional study was conducted at the Blood Collection Centre of HAH Centenary Hospital, New Delhi, India, from December 2019 to July 2020. A blood sample was collected from 155 subjects in each-sodium fluoride [Na2EDTA], heparin [sodium heparin] and Serum Separator Tube (SST). To find out the glucose reduction during blood coagulation in SST tubes, the glucose levels (n=25) of sodium fluoride (plasma) at 0 hr and 30 mins after coagulation in SST tubes were compared. The remaining study subjects (n=130) were categorised into two groups (65 subjects in each group) and assessed for the reduction of glucose at 4°C and 25°C. Further, the reduction of glucose was also studied in both the groups as per glucose concentrations <100 mg/dL (n=25), 100-200 mg/dL (n=25) and >200 mg/dL (n=15) in each group. Results: The inter assay coefficient of variation of quality control samples of glucose (n=61) was 3.0%. The highest percentage of glucose reduction was found in the green vacutainers (p<0.05) at 4°C and 25°C storage temperatures. There was no significant reduction of glucose level in SST vacutainers at 4°C up to 96 hrs of analysis (p>0.05) and the result was comparable to grey vacutainers. Further, there was no haemolysis in the SST vacutainers up to 96 hrs of analysis, however, green and grey vacutainers showed enormous haemolysis. Conclusion: The glucose analysis in SST vacutainers can reduce the loss of sample, cost of analysis, and interferences in the analysis due to haemolysis. The study strongly suggests that all the analytical laboratories should do glucose analysis in SST vacutainers.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270281","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/2022/50713.2576
Parthiban Rudrapathy, S. Samuel, S. Murugesan
Introduction: Bacterial infections, especially Bloodstream Infections (BSI) are among the most frequent complications in immunosuppressed patients with cancer, and are associated with considerable morbidity and mortality and high economic costs. Patients with chemotherapy induced neutropenia, especially haematological patients with malignancies in whom the neutropenia is often profound and prolonged, and those undergoing Haematopoietic Stem Cell Transplantation (HSCT) are at higher risk for BSI. Aim: To analyse the microbiological profile of Bloodstream Infections and their antibiotic resistance pattern among the clinically diagnosed cases of sepsis in cancer patients. Materials and Methods: This retrospective study was conducted at a Microbiology Division, Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Centre, Kannur, Kerala, India during the period from July 2020 to December 2020. Data of January 2016 to December 2017 on all microbial cultures from blood samples were analysed. All blood cultures during the study period were processed by Bactec 9050 Blood Culture System (Becton Dickinson Microbiology Systems, Sparks, MD, USA. After performing culture, bacterial identification and susceptibility was done by using automated culture system (VITEK 2 Compact system). Simple descriptive analysis of data was done and results presented in frequencies and percentages. Results: Total 385 (9.2%) were identified to be culture positive from 4154 blood cultures screened. Out of 385 positive cultures, 354 (92%) showed bacterial growth, gram negative were 245 (64%) and gram positive were 109 (28.3%) and fungal species were 31 (8%). Among the Gram negative bacteria (GNB), Klebsiella pneumoniae was found to be the most frequent species (n=83), followed by Escherichia coli (n=75). In gram positive bacteria, Coagulase-negative Staphylococci (CoNS) were the most common species (n=48). High prevalence of antimicrobial resistance was observed among E.coli, K.pneumoniae, Acinetobacter baumannii. Among the 48 isolates of CoNS and 26 isolates of S.aureus in which 30 (62.5%) isolates and 14 (54%) isolates respectively were found to be methicillin resistant. Conclusion: A proper antimicrobial stewardship should be followed in all healthcare centres especially cancer treating hospitals as the patients are immunocompromised. This current study on regular reporting of antibiogram with clinical guidelines will help in judicious use of antibiotics, as drug resistance is on the rise globally
{"title":"Microbiological Profile and Antibiotic Resistance of Bloodstream Infections among Cancer Patients at a Tertiary Care Cancer Centre in North Kerala, India","authors":"Parthiban Rudrapathy, S. Samuel, S. Murugesan","doi":"10.7860/njlm/2022/50713.2576","DOIUrl":"https://doi.org/10.7860/njlm/2022/50713.2576","url":null,"abstract":"Introduction: Bacterial infections, especially Bloodstream Infections (BSI) are among the most frequent complications in immunosuppressed patients with cancer, and are associated with considerable morbidity and mortality and high economic costs. Patients with chemotherapy induced neutropenia, especially haematological patients with malignancies in whom the neutropenia is often profound and prolonged, and those undergoing Haematopoietic Stem Cell Transplantation (HSCT) are at higher risk for BSI. Aim: To analyse the microbiological profile of Bloodstream Infections and their antibiotic resistance pattern among the clinically diagnosed cases of sepsis in cancer patients. Materials and Methods: This retrospective study was conducted at a Microbiology Division, Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Centre, Kannur, Kerala, India during the period from July 2020 to December 2020. Data of January 2016 to December 2017 on all microbial cultures from blood samples were analysed. All blood cultures during the study period were processed by Bactec 9050 Blood Culture System (Becton Dickinson Microbiology Systems, Sparks, MD, USA. After performing culture, bacterial identification and susceptibility was done by using automated culture system (VITEK 2 Compact system). Simple descriptive analysis of data was done and results presented in frequencies and percentages. Results: Total 385 (9.2%) were identified to be culture positive from 4154 blood cultures screened. Out of 385 positive cultures, 354 (92%) showed bacterial growth, gram negative were 245 (64%) and gram positive were 109 (28.3%) and fungal species were 31 (8%). Among the Gram negative bacteria (GNB), Klebsiella pneumoniae was found to be the most frequent species (n=83), followed by Escherichia coli (n=75). In gram positive bacteria, Coagulase-negative Staphylococci (CoNS) were the most common species (n=48). High prevalence of antimicrobial resistance was observed among E.coli, K.pneumoniae, Acinetobacter baumannii. Among the 48 isolates of CoNS and 26 isolates of S.aureus in which 30 (62.5%) isolates and 14 (54%) isolates respectively were found to be methicillin resistant. Conclusion: A proper antimicrobial stewardship should be followed in all healthcare centres especially cancer treating hospitals as the patients are immunocompromised. This current study on regular reporting of antibiogram with clinical guidelines will help in judicious use of antibiotics, as drug resistance is on the rise globally","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270379","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/2022/52218.2595
R. Rastogi, D. Kalita, P. Rastogi, G. Bhatnagar
Adrenal myelolipomas are a variety of rare and endocrinologically non functional benign neoplasms of the adrenal gland. They are usually composed of haematopoietic elements with interspersed areas of fatty tissue, thus, resembling bone marrow tissue. These tumours are usually detected as an incidentaloma during routine scans on suspicion of other diagnoses and are mostly silent clinically. They have always been a subject of diagnostic dilemmas for the clinicians, as they are usually asymptomatic and benign, but are often operated upon in situations where a malignancy cannot be excluded. Differential diagnosis for these tumours include adrenal adenoma, adrenal carcinoma, retroperitoneal liposarcoma and renal angiomyolipomas. A careful histopathological examination usually settles the diagnosis. Usually, the tumours are unilateral with right sided preponderance and are small in size. Here, the authors report three interesting cases, including two females and one male, of adrenal myelolipomas with varied presentations with two cases presenting with large size tumours and in one case the adrenal tumour was located on left side.
{"title":"Adrenal Myelolipomas: An Interesting Case Series of the Silent Tumours with a Diagnostic Dilemma","authors":"R. Rastogi, D. Kalita, P. Rastogi, G. Bhatnagar","doi":"10.7860/njlm/2022/52218.2595","DOIUrl":"https://doi.org/10.7860/njlm/2022/52218.2595","url":null,"abstract":"Adrenal myelolipomas are a variety of rare and endocrinologically non functional benign neoplasms of the adrenal gland. They are usually composed of haematopoietic elements with interspersed areas of fatty tissue, thus, resembling bone marrow tissue. These tumours are usually detected as an incidentaloma during routine scans on suspicion of other diagnoses and are mostly silent clinically. They have always been a subject of diagnostic dilemmas for the clinicians, as they are usually asymptomatic and benign, but are often operated upon in situations where a malignancy cannot be excluded. Differential diagnosis for these tumours include adrenal adenoma, adrenal carcinoma, retroperitoneal liposarcoma and renal angiomyolipomas. A careful histopathological examination usually settles the diagnosis. Usually, the tumours are unilateral with right sided preponderance and are small in size. Here, the authors report three interesting cases, including two females and one male, of adrenal myelolipomas with varied presentations with two cases presenting with large size tumours and in one case the adrenal tumour was located on left side.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270988","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/2022/53716.2648
N. Reddi, Gaddiparthi Israel
{"title":"Antibiotic Sensitivity Pattern of Non Fermentative Gram Negative Bacilli in a Tertiary Care Hospital, Kakinada, Andhra Pradesh, India","authors":"N. Reddi, Gaddiparthi Israel","doi":"10.7860/njlm/2022/53716.2648","DOIUrl":"https://doi.org/10.7860/njlm/2022/53716.2648","url":null,"abstract":"","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271050","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/2022/56319.2676
N. Mishra, Dayavanti Kumari, Aditya K Mishra
Introduction: The presence of Candida in urine, called Candiduria. Immunocompromised individuals are more susceptible to this infection and it can cause life-threatening complications. Candida albicans is most common isolate in Urinary Tract Infections (UTI) but in recent years this is shifting to non-albicans groups. Researchers found that azole is the drug of choice against Candida infections but due to excess use of these drugs resistance is developing more frequently for azole group drugs and drug resistant isolates are increasing gradually. A unique virulence factor i.e biofilm production, similarly like bacterial species is a crucial factor which contributes to the resistance against antifungal drugs. Aim: To assess the prevalence of Candida spp. in UTI retrospectively. Materials and Methods: The present retrospective study was conducted in Department of Microbiology, T.S Misra Medical College, Lucknow, Uttar-Pradesh, India from January 2018 to February 2020. A total of 1576 urine samples were collected from different wards of hospitals and Intensive Care Unit (ICU) with age group 0-80 years. Out of 1576 urine samples received, 786 had fungal growth, from which 176 Candida spp. were isolated. Candidauria and Candida UTIs data were collected from Institute's microbiology records retrospectively. The obtained results were statistically analysed in numbers and percentages using MS Excel 2013 version. Result: The prevalence of Candida species was 11.2%. The age group between 21-30 years was more prevalent. Diabetes mellitus was the main co-morbidity factor in Candiduria patients. The incidence rate was high in ICU patients 161 (91.5%) than non ICU patients (8.5%). Most the samples were isolated from general medicine (45.3%) and Obstetrics and Gynaecology department (34.8%) followed by general surgery (15.5%) and pediatric department (4.4%). Conclusion: Present study found the high prevalence of candiduria and the isolates were biofilm producers with increasing resistance against most common drugs fluconazole which is a major concern for the treatment and management aspects. In immunocompromised patients, it is important to identify the species of Candida isolates as well as their antifungal susceptibility pattern to assist the clinicians in treating the patients with candiduria.
{"title":"Prevalence of Candida species in Urinary Tract Infections from a Tertiary Care Hospital at Lucknow, Uttar Pradesh, India: A Retrospective Study","authors":"N. Mishra, Dayavanti Kumari, Aditya K Mishra","doi":"10.7860/njlm/2022/56319.2676","DOIUrl":"https://doi.org/10.7860/njlm/2022/56319.2676","url":null,"abstract":"Introduction: The presence of Candida in urine, called Candiduria. Immunocompromised individuals are more susceptible to this infection and it can cause life-threatening complications. Candida albicans is most common isolate in Urinary Tract Infections (UTI) but in recent years this is shifting to non-albicans groups. Researchers found that azole is the drug of choice against Candida infections but due to excess use of these drugs resistance is developing more frequently for azole group drugs and drug resistant isolates are increasing gradually. A unique virulence factor i.e biofilm production, similarly like bacterial species is a crucial factor which contributes to the resistance against antifungal drugs. Aim: To assess the prevalence of Candida spp. in UTI retrospectively. Materials and Methods: The present retrospective study was conducted in Department of Microbiology, T.S Misra Medical College, Lucknow, Uttar-Pradesh, India from January 2018 to February 2020. A total of 1576 urine samples were collected from different wards of hospitals and Intensive Care Unit (ICU) with age group 0-80 years. Out of 1576 urine samples received, 786 had fungal growth, from which 176 Candida spp. were isolated. Candidauria and Candida UTIs data were collected from Institute's microbiology records retrospectively. The obtained results were statistically analysed in numbers and percentages using MS Excel 2013 version. Result: The prevalence of Candida species was 11.2%. The age group between 21-30 years was more prevalent. Diabetes mellitus was the main co-morbidity factor in Candiduria patients. The incidence rate was high in ICU patients 161 (91.5%) than non ICU patients (8.5%). Most the samples were isolated from general medicine (45.3%) and Obstetrics and Gynaecology department (34.8%) followed by general surgery (15.5%) and pediatric department (4.4%). Conclusion: Present study found the high prevalence of candiduria and the isolates were biofilm producers with increasing resistance against most common drugs fluconazole which is a major concern for the treatment and management aspects. In immunocompromised patients, it is important to identify the species of Candida isolates as well as their antifungal susceptibility pattern to assist the clinicians in treating the patients with candiduria.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271076","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/2022/55484.2661
Biswanath Paul, Priyaranjan Chattopadhyay, A. Bhattacharyya, D. Bhattacharjee
Introduction: The carcinoma of gallbladder is the most common malignancy of the biliary tract. The incidence of this carcinoma varies geographically. Incidental gallbladder carcinoma is diagnosed during histopathological examination after cholecystectomy due to other reasons. Histopathological examination of all cholecystectomy specimens are very essential to rule out these incidental gallbladder carcinomas. Aim: To this study to estimate the frequency of incidental gallbladder carcinoma in patients undergoing routine cholecystectomy and also to evaluate the necessity of routine histopathological examination after all cholecystectomy. Materials and Methods: A retrospective observational study was conducted in Department of Pathology, Midnapore Medical College and Hospital, West Bengal, India between January 2014 to December 2019 (six years) covering 650 patients who underwent laparoscopic and open cholecystectomy. Patients' demographic data, pathologic results, macroscopic appearance of the specimen, cancer staging were recorded and frequency of incidental gallbladder carcinoma were calculated. Result: Total 650 cholecystectomy specimens due to benign gallbladder disease were received in pathology department. Histopathological examination revealed 18 cases of incidental gallbladder carcinoma which comprised 2.8% of all the cholecystectomies. Among them 13 were female and five were in male with male: female ratio of 1:2.6 and the age ranges from 35 to 68 years. Among 18 cases 10 cases showed invasion upto lamina propria (stage T1a), five) cases had invasion in muscular layer (stage T1b) and three cases showed perimuscular connective tissue invasion (stage T2a). Conclution: The present study observed that the incidence of incidental gallbladder carcinoma in cholecystectomy specimen was little higher range in East Indian population and so routine histopathological examination of all cholecystectomy specimens are recommended.
{"title":"Incidental Gallbladder Carcinoma: An Eastern Indian Experience and Necessity of Routine Histopathological Examination after All Cholecystectomy","authors":"Biswanath Paul, Priyaranjan Chattopadhyay, A. Bhattacharyya, D. Bhattacharjee","doi":"10.7860/njlm/2022/55484.2661","DOIUrl":"https://doi.org/10.7860/njlm/2022/55484.2661","url":null,"abstract":"Introduction: The carcinoma of gallbladder is the most common malignancy of the biliary tract. The incidence of this carcinoma varies geographically. Incidental gallbladder carcinoma is diagnosed during histopathological examination after cholecystectomy due to other reasons. Histopathological examination of all cholecystectomy specimens are very essential to rule out these incidental gallbladder carcinomas. Aim: To this study to estimate the frequency of incidental gallbladder carcinoma in patients undergoing routine cholecystectomy and also to evaluate the necessity of routine histopathological examination after all cholecystectomy. Materials and Methods: A retrospective observational study was conducted in Department of Pathology, Midnapore Medical College and Hospital, West Bengal, India between January 2014 to December 2019 (six years) covering 650 patients who underwent laparoscopic and open cholecystectomy. Patients' demographic data, pathologic results, macroscopic appearance of the specimen, cancer staging were recorded and frequency of incidental gallbladder carcinoma were calculated. Result: Total 650 cholecystectomy specimens due to benign gallbladder disease were received in pathology department. Histopathological examination revealed 18 cases of incidental gallbladder carcinoma which comprised 2.8% of all the cholecystectomies. Among them 13 were female and five were in male with male: female ratio of 1:2.6 and the age ranges from 35 to 68 years. Among 18 cases 10 cases showed invasion upto lamina propria (stage T1a), five) cases had invasion in muscular layer (stage T1b) and three cases showed perimuscular connective tissue invasion (stage T2a). Conclution: The present study observed that the incidence of incidental gallbladder carcinoma in cholecystectomy specimen was little higher range in East Indian population and so routine histopathological examination of all cholecystectomy specimens are recommended.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271278","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/2022/50427.2614
R. Ingin, Ashwin P. Khageshan, M. Patil, Jagadish M Kattimani, Kirthi Shivasharanappa Patil
Introduction: Transfusion of blood and its components is a life- saving manoeuvre but has life threatening hazards as well. Blood Transfusion Service (BTS) is covered by “Drug and Cosmetics Act” and has legal implications. Hence, strict criteriae are followed while selecting a donor, particularly emphasising on Transfusion Transmissible Infections (TTI), which may improve safe transfusion practices. Aim: To study the seroprevalence of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) among Voluntary Donors (VD) in blood centre, tertiary care hospital, Kalaburagi, Karnataka, India. Materials and Methods: The present study was retrospective observational study done for four consecutive years from 1st January 2017 to 31st December 2020. Data of all donors screened for HIV, HBV and HCV was retrieved from the records of Gulbarga Institute Medical Sciences (GIMS) Blood Centre, GIMS Hospital, Kalaburagi, Karnataka, India. The results were tabulated and analysed using descriptive statistics.. Results: Total blood units taken were 15,466 from VDs. There were 96.8% (14,966/15,466) male and 3.2% (500/15,466) female donors. The overall seropositivity of HBV, HCV and HIV was 1.8%, 0.006% and 0.12%, respectively. The highest seroprevalence of TTI was found to be in the age group of 18-30 years (169 donors; 55.6%) followed by 31-40 years age group (103 donors; 33.9%). Conclusion: This study shows increasing trend for total blood donation. Strict selection and retention of voluntary low-risk blood donors is recommended to improve the blood safety. Use of highly sensitive screening tests like Nucleic Acid Amplification Test (NAAT) technology may be implemented in all blood centres to possibly reduce the incidence of TTI.
{"title":"Seroprevalence of Blood-borne Viral Infections among Blood Donors in a Tertiary Care Hospital, Kalaburagi District, Karnataka, India","authors":"R. Ingin, Ashwin P. Khageshan, M. Patil, Jagadish M Kattimani, Kirthi Shivasharanappa Patil","doi":"10.7860/njlm/2022/50427.2614","DOIUrl":"https://doi.org/10.7860/njlm/2022/50427.2614","url":null,"abstract":"Introduction: Transfusion of blood and its components is a life- saving manoeuvre but has life threatening hazards as well. Blood Transfusion Service (BTS) is covered by “Drug and Cosmetics Act” and has legal implications. Hence, strict criteriae are followed while selecting a donor, particularly emphasising on Transfusion Transmissible Infections (TTI), which may improve safe transfusion practices. Aim: To study the seroprevalence of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) among Voluntary Donors (VD) in blood centre, tertiary care hospital, Kalaburagi, Karnataka, India. Materials and Methods: The present study was retrospective observational study done for four consecutive years from 1st January 2017 to 31st December 2020. Data of all donors screened for HIV, HBV and HCV was retrieved from the records of Gulbarga Institute Medical Sciences (GIMS) Blood Centre, GIMS Hospital, Kalaburagi, Karnataka, India. The results were tabulated and analysed using descriptive statistics.. Results: Total blood units taken were 15,466 from VDs. There were 96.8% (14,966/15,466) male and 3.2% (500/15,466) female donors. The overall seropositivity of HBV, HCV and HIV was 1.8%, 0.006% and 0.12%, respectively. The highest seroprevalence of TTI was found to be in the age group of 18-30 years (169 donors; 55.6%) followed by 31-40 years age group (103 donors; 33.9%). Conclusion: This study shows increasing trend for total blood donation. Strict selection and retention of voluntary low-risk blood donors is recommended to improve the blood safety. Use of highly sensitive screening tests like Nucleic Acid Amplification Test (NAAT) technology may be implemented in all blood centres to possibly reduce the incidence of TTI.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270201","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/2022/51722.2589
S. Samuel, O. Neeraja, R. Parthiban, M. Saravanan, K. Sarath
Introduction: Cancer patients are disproportionately at high risk of developing infections, with a risk of infection about 10 times than that of non cancer patients. Extended Spectrum Beta-Lactamases (ESBLs) enzyme producing gram-negative bacteria have been marked as one of the “serious” threat by the centre for disease control. This enzyme has the ability to hydrolyse the beta-lactam antibiotics and posses a major threat for the immunocompromised and cancer patients. Hence, understanding its prevalence at the grammatical level is important to decide upon the type of drugs to be prescribed. Aim: To study the prevalence of ESBL genes among the Gram- Negative Bacteria (GNB) isolated from cancer patients. Materials and Methods: The present study was a hospital- based cross-sectional study carried out in Microbiology Division, Malabar Cancer Centre, Thalassery, Kerala, India, from January to March 2021. Microbiological identification of the causative agents was done by staining, culturing and biochemical methods. Screening of the isolates for ESBL was done using Double Disc Synergy Test (DDST). Antibiotic susceptibility testing was carried out using modified Kirby-Bauer disc diffusion method. The ESBL producers were genotypically confirmed through Polymerase Chain Reaction (PCR) and typed accordingly. The data were given as average with standard deviation and analysed using Microsoft Excel. Results: Out of 1,310 specimens, 366 (27.9%) were culture positive. Among the GNB, Escherichia coli (50%) followed by Klebsiella pneumoniae (46.07%), Proteus (1.96%) and Enterobacter cloacae (0.98%) were the predominant isolates. Most of these ESBL producers (Escherichia coli, Klebsiella pneumoniae) were Multidrug Resistant (MDR). However, significant isolates of Escherichia coli (98.03%), Klebsiella pneumoniae (36.1%), Proteus, (50%) and Enterobacter cloacae (100%) were sensitive to immunocompromised. Among 102 ESBL producers, prevalence of blaTEM (67.64%) was highest followed by blaCTX-M (10.78%), blaSHV (14.70%) and blaOXA (18.62%). All of the ESBL producers tested showed the presence of one of four beta- lactamase encoding genes by PCR. One of the isolate Proteus mirabilis found to be ESBL producer as confirmed by phenotypic methods but lacked ESBL genes. Conclusion: Higher prevalence of ESBL producing strains warrants stringent measures to tackle the spread of MDR strains. Carbapenems can be considered as the drug of choice against ESBL producers. Highly prevalent blaTEM gene could be considered as potential therapeutical and diagnostic target against the ESBL producing GNBs.
{"title":"Prevalence of Extended Spectrum Beta-lactamase Encoding Genes in Enterobacteriaceae Isolated from Various Clinical Samples in a Tertiary Care Cancer Centre, Kerala, India","authors":"S. Samuel, O. Neeraja, R. Parthiban, M. Saravanan, K. Sarath","doi":"10.7860/njlm/2022/51722.2589","DOIUrl":"https://doi.org/10.7860/njlm/2022/51722.2589","url":null,"abstract":"Introduction: Cancer patients are disproportionately at high risk of developing infections, with a risk of infection about 10 times than that of non cancer patients. Extended Spectrum Beta-Lactamases (ESBLs) enzyme producing gram-negative bacteria have been marked as one of the “serious” threat by the centre for disease control. This enzyme has the ability to hydrolyse the beta-lactam antibiotics and posses a major threat for the immunocompromised and cancer patients. Hence, understanding its prevalence at the grammatical level is important to decide upon the type of drugs to be prescribed. Aim: To study the prevalence of ESBL genes among the Gram- Negative Bacteria (GNB) isolated from cancer patients. Materials and Methods: The present study was a hospital- based cross-sectional study carried out in Microbiology Division, Malabar Cancer Centre, Thalassery, Kerala, India, from January to March 2021. Microbiological identification of the causative agents was done by staining, culturing and biochemical methods. Screening of the isolates for ESBL was done using Double Disc Synergy Test (DDST). Antibiotic susceptibility testing was carried out using modified Kirby-Bauer disc diffusion method. The ESBL producers were genotypically confirmed through Polymerase Chain Reaction (PCR) and typed accordingly. The data were given as average with standard deviation and analysed using Microsoft Excel. Results: Out of 1,310 specimens, 366 (27.9%) were culture positive. Among the GNB, Escherichia coli (50%) followed by Klebsiella pneumoniae (46.07%), Proteus (1.96%) and Enterobacter cloacae (0.98%) were the predominant isolates. Most of these ESBL producers (Escherichia coli, Klebsiella pneumoniae) were Multidrug Resistant (MDR). However, significant isolates of Escherichia coli (98.03%), Klebsiella pneumoniae (36.1%), Proteus, (50%) and Enterobacter cloacae (100%) were sensitive to immunocompromised. Among 102 ESBL producers, prevalence of blaTEM (67.64%) was highest followed by blaCTX-M (10.78%), blaSHV (14.70%) and blaOXA (18.62%). All of the ESBL producers tested showed the presence of one of four beta- lactamase encoding genes by PCR. One of the isolate Proteus mirabilis found to be ESBL producer as confirmed by phenotypic methods but lacked ESBL genes. Conclusion: Higher prevalence of ESBL producing strains warrants stringent measures to tackle the spread of MDR strains. Carbapenems can be considered as the drug of choice against ESBL producers. Highly prevalent blaTEM gene could be considered as potential therapeutical and diagnostic target against the ESBL producing GNBs.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270223","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/2022/52700.2638
Neelima Govada, Kaumudi Konkay, Neelima Pola, P. Chaganti, Chandana Chowdary Yarra, M. Karri
Introduction: Ectopic Pregnancy (EP) is defined as a pregnancy that occurs in ectopic location, that is, outside the cavity of uterus. It is one of the leading causes of mortality in the first trimester of pregnancy and one of indication for emergency laparotomy. Timely diagnosis is extremely crucial as delay in diagnosis can lead to mortality. Diagnosing ectopic pregnancy is quiet challenging as there are many conditions which have similar presentation and may not require surgical management. Histopathology is required for confirmation of ectopic pregnancy by identifying trophoblastic tissue in ectopic location since there are other conditions like haematosalpinx, ruptured hemorrhagic corpus luteum which can have similar presentation clinically. Aim: To analyse the clinicopathological features of cases clinically diagnosed as ectopic pregnancy and estimate the percentage of cases which were confirmed on histopathology and assess the percentage of cases which were negative on histopathology. Materials and Methods: This was a retrospective observational study conducted on three years data collected retrospectively between July 2017 and June 2020. Clinical details like age of the patient, parity, gestational age, previous history of any associated risk factors for ectopic pregnancy, were obtained from patient requisition forms and pathology records. Hematoxylin and Eosin (H & E) stained sections were reviewed. Descriptive analysis was done. Data entry was made in Microsoft (MS) excel sheet. Frequencies and percentages were calculated. Results: Total of 128 cases (mean age 25.8±4.87 years) data was analysed in this study, most women were between 21 to 30 years (97 out of 128 (75.7%), with mean age of 25.8 years and presented in 2nd pregnancy (40 out of 86 cases where details were known (46.5%) and in 6th week of gestation (28 out of 78 cases where details were known) (35.8%)) with mean gestational age of 7.2 weeks. Most common risk factors were previous abortions and previous caesarean section (36 out of 82 cases where details were known (43.9% each)). Fallopian tube was the most common site (112 out of 113 cases, 99.1%). On histopathological examination, trophoblastic tissue was identified in 116 cases out of 128 cases. (90.6%). Twelve cases showed no evidence of trophoblastic tissues (11.7%), of these, three cases (25%) showed ruptured corpus luteum, seven cases (40%) showed hematosalpinx, and two cases (13.3%) showed chronic salpingitis changes. Conclusion: Ectopic pregnancy was most frequent in women between 21 to 30 years, in 2nd pregnancy and in 6th week of gestation. Most common risk factors were previous abortions and previous caesarean section. Fallopian tube was the most common site. Ectopic pregnancy was confirmed on histopathological examination, 90.6% cases. A total of 11.7% cases which showed no evidence of trophoblastic tissues, were cases of Haematosalpinx, ruptured hemorrhagic corpus luteum and chronic salpingitis and they presented
{"title":"Clinical and Histopathological Findings of Ectopic Pregnancy Cases- A Retrospective Study from a Tertiary Care Hospital, Andhra Pradesh, India","authors":"Neelima Govada, Kaumudi Konkay, Neelima Pola, P. Chaganti, Chandana Chowdary Yarra, M. Karri","doi":"10.7860/njlm/2022/52700.2638","DOIUrl":"https://doi.org/10.7860/njlm/2022/52700.2638","url":null,"abstract":"Introduction: Ectopic Pregnancy (EP) is defined as a pregnancy that occurs in ectopic location, that is, outside the cavity of uterus. It is one of the leading causes of mortality in the first trimester of pregnancy and one of indication for emergency laparotomy. Timely diagnosis is extremely crucial as delay in diagnosis can lead to mortality. Diagnosing ectopic pregnancy is quiet challenging as there are many conditions which have similar presentation and may not require surgical management. Histopathology is required for confirmation of ectopic pregnancy by identifying trophoblastic tissue in ectopic location since there are other conditions like haematosalpinx, ruptured hemorrhagic corpus luteum which can have similar presentation clinically. Aim: To analyse the clinicopathological features of cases clinically diagnosed as ectopic pregnancy and estimate the percentage of cases which were confirmed on histopathology and assess the percentage of cases which were negative on histopathology. Materials and Methods: This was a retrospective observational study conducted on three years data collected retrospectively between July 2017 and June 2020. Clinical details like age of the patient, parity, gestational age, previous history of any associated risk factors for ectopic pregnancy, were obtained from patient requisition forms and pathology records. Hematoxylin and Eosin (H & E) stained sections were reviewed. Descriptive analysis was done. Data entry was made in Microsoft (MS) excel sheet. Frequencies and percentages were calculated. Results: Total of 128 cases (mean age 25.8±4.87 years) data was analysed in this study, most women were between 21 to 30 years (97 out of 128 (75.7%), with mean age of 25.8 years and presented in 2nd pregnancy (40 out of 86 cases where details were known (46.5%) and in 6th week of gestation (28 out of 78 cases where details were known) (35.8%)) with mean gestational age of 7.2 weeks. Most common risk factors were previous abortions and previous caesarean section (36 out of 82 cases where details were known (43.9% each)). Fallopian tube was the most common site (112 out of 113 cases, 99.1%). On histopathological examination, trophoblastic tissue was identified in 116 cases out of 128 cases. (90.6%). Twelve cases showed no evidence of trophoblastic tissues (11.7%), of these, three cases (25%) showed ruptured corpus luteum, seven cases (40%) showed hematosalpinx, and two cases (13.3%) showed chronic salpingitis changes. Conclusion: Ectopic pregnancy was most frequent in women between 21 to 30 years, in 2nd pregnancy and in 6th week of gestation. Most common risk factors were previous abortions and previous caesarean section. Fallopian tube was the most common site. Ectopic pregnancy was confirmed on histopathological examination, 90.6% cases. A total of 11.7% cases which showed no evidence of trophoblastic tissues, were cases of Haematosalpinx, ruptured hemorrhagic corpus luteum and chronic salpingitis and they presented","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270538","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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