National Journal of Laboratory Medicine最新文献

{"title":"Evaluation of Cytological Scoring and Comparison with Histopathological Finding in a Palpable Breast Lump","authors":"Margaret Theresa Joseph, Fathima Jackia Banu, G. Rakesh","doi":"10.7860/njlm/2022/52142.2640","DOIUrl":"https://doi.org/10.7860/njlm/2022/52142.2640","url":null,"abstract":"Introduction: Breast cancer is the commonest malignancy worldwide in women. Preoperative evaluation of breast lump plays a major role in the early diagnosis and management of the breast lesions. This study helps in subgrouping the breast lesions into various categories and provides the line of management of each category accordingly. Aim: To evaluate the cytomorphology of various breast lesions, to compare with histopathological findings and to assess the usefulness of Modified Masood’s Scoring Index (MMSI) in palpable breast lumps. Materials and Methods: This was a cross-sectional study done in 61 female patients presented with palpable breast lump between March 2019 and February 2021 at Pathology Department, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India. Cytological examination along with MMSI was applied on Fine Needle Aspiration Cytology (FNAC) aspirates, followed by histological confirmation. Under MMSI, the breast lesions were categorised into four groups: Non Proliferative Breast Disease (Non PBD), PBD without atypia, PBD with atypia and carcinoma breast. The data were collected and complied in Microsoft excel programme, appropriate graphs were made and percentages were calculated. Results: Total of 61 cases were analysed, females with age range of 23 to 64 years, mean age of 38 years. Majority of the cases presented with unilateral breast lump (92.5%). In MMSI Scoring, 15/61 (24.5%) were found with the score of 6 followed by 12/61 (19.6%) score of 8 which falls under NPBD. Total of cases 2/61 (3.2%) score of 24 while 3/61 (4.9%) with the score of 23 fell under Carcinoma breast category. Overall concordance observed between MMSI and histopathology was 59/61 cases which is 96.72%, which indicates the high degree of concordance with histopathological diagnosis. Conclusion: MMSI is a simple and reliable scoring system and can be applied on FNAC aspirates. MMSI increase the diagnostic accuracy and provide better concordance with histopathology.","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":"71270811","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}

{"title":"Association of Serum Adiponectin Level with Dyslipidaemia in North Indian Male Population: A Case-control Study","authors":"Ranadip Mukherjee, M. K. Misra, S. Samanta, Kajal Mahajan, Devajit Sarmah, M. Mukherjee","doi":"10.7860/njlm/2022/56393.2652","DOIUrl":"https://doi.org/10.7860/njlm/2022/56393.2652","url":null,"abstract":"Introduction: Adiponectin is the most abundant adipocytokines secreted from adipose tissues and circulates in considerably high concentration in human plasma. Circulating adiponectin levels are decreased in obese subjects and this decrease has been thought to play a crucial role in the early development of atherosclerosis and cardiovascular diseases. Changes in adiponectin concentration has been reported in dyslipidemic subjects, but the evidence is controversial and no study conducted in north Indian population. Moreover, low molecular adiponectin seems to be linked with a worse lipid profile leading to dyslipidaemic through an association with triglyceride but the exact role of adiponectin in modulating lipid fraction is not well established. Aim: To correlate the level of serum adiponectin with lipid fractions in dyslipidemic male subjects and also to compare them with apparently healthy individuals. Materials and Methods: This case control study was conducted from April 2015 to November 2016 in the Biochemistry department of Rajshree Medical Research institute, Bareilly, Uttar Pradesh, India. A total of 70 non diabetic dyslipidemic male subjects between the age group 35 years to 55 years were selected and all the biochemical parameters (adiponectin, fasting plasma glucose, lipid profile) were evaluated and compared with 70 apparently healthy controls. Statistical analysis was performed by licensed version of Statistical Package for Social Sciences (SPSS) 16.0 software. All the data were expressed in “mean±SD”. Student ‘t’ test was also applied to see statistical significance in adiponectin levels between dyslipidemic subjects and healthy controls. Results: The study shows mean±SD of age in dyslipidemic group was 43.61±4.85 years and for control group was 43.53±5.53 years. The mean±SD of BMI in dyslipidemic group 25.72±2.43 was significantly higher than control group 23.42±1.56 with p-value <0.0001. The serum adiponectin concentration was significantly reduced in dyslipidemic subjects 5.11±2.04 μg/mL as compared to healthy control 6.79±1.37 μg/mL with p-value <0.0001. Serum total cholesterol, triglyceride and Low Density Lipoprotein (LDL)- cholesterol were found to be negatively correlated with serum adiponectin (r= -0.89, -0.76 and -0.74) and positively correlated with High Density Lipoprotein (HDL)-cholesterol (r= 0.70). Conclusion: The present study revealed that hypoadiponectinemia is associated with dyslipidaemic in men. The main observation of our present study, however, is that in dyslipidemic subjects, lower levels of adiponectin were associated with high total cholesterol, triglyceride, LDL-cholesterol and reduced HDL cholesterol, though more extensive, multicentric, prospective research with increase sample size could obtain wider insights.","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":"71271131","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}

{"title":"Comparison of Conventional Pap Smears versus Liquid Based Cytology for Clinicopathological Patterns of Cervical Lesions at a Tertiary Care Centre, Bangalore, India","authors":"C. Anushree, Sonal Priyanker, Nagaraj Narasappa Hugar, Y. Manjunatha","doi":"10.7860/njlm/2022/56671.2662","DOIUrl":"https://doi.org/10.7860/njlm/2022/56671.2662","url":null,"abstract":"Introduction: Conventional Pap Smear (CPS) technique has been the mainstay for early detection of cervical cancer. However, its extensive use has not been possible due to the limitations, like presence of obscuring blood and inflammation, reducing its sensitivity markedly. False negativity of CPS is also very high so Liquid Based Cytology (LBC) was introduced. Aim: To compare cytomorphological patterns, diagnostic utility and adequacy of smears of cervical lesions on CPS and LBC. Materials and Methods: This study was a Prospective descriptive study, conducted in Department of Pathology of Dr. B R Ambedkar Medical College and Hospital, Bangalore for 19 months during November 2018 to May 2020 on 250 cases. The samples were taken with cervix-brush. First, a CPS was prepared and was immediately alcohol-fixed. After that same brush head was rinsed in LBC vial containing methanol. Statistical analysis was done using Statistical Package for Social Sciences 22.0 (SPSS) and R environment 3.2.2 for data analysis. Results: Most of the patients were in the fourth decade of life and 160 cases (64%) presented as white discharge per vaginum. Total 231 (92.4%) smears were satisfactory on CPS and 233 (93.2%) smears on LBC. The number of Low grade Squamous Intraepithelial Lesions (LSIL) increased from 4 cases (1.6%) in CPS to 6 cases (2.4%) in LBC in this study. Rate of detection of High grade Squamous Intraepithelial Lesion (HSIL) was more with LBC (11 cases, 4.4%) compared to that of CPS (7 cases, 2.8%). It was seen that in this study, sensitivity and specificity of LBC is better than CP in detecting LSIL and HSIL, but except specificity of CP was more than LBC in detecting LSIL. Present study showed overall sensitivity of 77.1% in CP and 94.3% in LBC and specificity of 97.2% and 100% in CP and LBC, respectively. The p-value calculated was <0.001 which was highly significant. Conclusion: The LBC technique showed clear background, well preserved cytomorphological details, removal of extra mucus, blood and inflammatory cell infiltrate as compared to CPS technique. Atypical cells or abnormal cells were seen better and were detected more by LBC as compared to CPS.","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":"71271190","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}

{"title":"Group B Streptococcal Colonisation among Antenatal Women from a Tertiary Care Centre, Northern Kerala: A Cross-sectional Study","authors":"J. K. Mathew, Maya Sudhakaran, Mb Shabina, N. Menon","doi":"10.7860/njlm/2022/57242.2672","DOIUrl":"https://doi.org/10.7860/njlm/2022/57242.2672","url":null,"abstract":"Introduction: Group B Streptococcus (GBS) is the leading cause of neonatal sepsis all over the world. Maternal colonisation of GBS in vaginal and anorectal area poses risk for subsequent invasive disease. The prevalence of maternal colonisation varies with geographical, biological and socio-economical factors. Current recommendations consider maternal screening and antibiotic therapy to prevent GBS neonatal disease with a potential of alteration of infant gut flora. Aim: To find out the prevalence, outcome and antimicrobial susceptibility pattern of the GBS colonisation in antenatal women. Materials and Methods: A hospital-based descriptive crosssectional study was conducted in Government Medical College, Kozhikode, Kerala, India, during December 2017 to May 2019 including 300 antenatal women of 35-37 weeks gestational age. Vaginal and rectal swabs were taken and were subjected to microbiological examination and culture. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 16.0. The Chi-square test and Fisher’s exact test were used wherever applicable and p-value <0.05 is considered significant. Results: Among the 300 antenatal women, 8 (2.7%) were colonised with GBS. Higher rate of colonisation was observed in women of 21-25 years, higher parity, rural dwelling and in women with poor glycaemic control. All the colonised women received antibiotic prophylaxis with intravenous ampicillin. None of the colonised women or the neonates born to them developed any invasive GBS infection. Antibiotic susceptibility testing showed that all the isolates were sensitive to penicillin, ampicillin and vancomycin but only 62.5% of the isolates were susceptible to clindamycin and 37.5% of the isolates were susceptible to erythromycin. Conclusion: The prevalence of GBS colonisation is low in Asian countries, compared to the data from western countries. Evidence based usage of narrow spectrum antibiotics should be considered. Further studies regarding prevalence, antibiotic susceptibility pattern, cost benefit analysis of the antibiotic usage and its effect on neonatal gut flora etc, including a wider population, is a need of the hour in the setting of emergence of resistance.","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":"71271241","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}

{"title":"Clinical Characteristics and Risk Factors for Mortality in COVID-19 Patients at a Tertiary Care Centre in Southern Assam, India: A Retrospective Study","authors":"Riturag Thakuria, Nabaruna Paul, P. Baruah, P. Choudhury","doi":"10.7860/njlm/2022/57788.2681","DOIUrl":"https://doi.org/10.7860/njlm/2022/57788.2681","url":null,"abstract":"Introduction: Coronavirus Disease-2019 (COVID-19) infection can cause a wide range of symptoms, from asymptomatic infection and mild upper respiratory tract disease to severe viral pneumonia with respiratory failure and multiorgan malfunction. Through this study, effort was put forward to know the COVID-19 in terms of clinical characteristics, risk factors and laboratory parameters which in turn may serve as predictors of severe sickness and negative outcomes of COVID-19. Aim: To study the clinical characteristics, risk factors and laboratory parameters of COVID-19 patients in a part of North Eastern India, and also to compare these parameters between survivors and non survivors. Materials and Methods: This retrospective study was conducted in Silchar Medical College and Hospital, Silchar, Assam, India. Study included all patients of COVID-19 diagnosed by Reverse Transcriptase Polymerase Chain Reaction (RTPCR) or Rapid Antigen Test (RAT) admitted from 1st July, 2020 to 31st December, 2020. The data included demographic parameters, presenting symptoms, significant medical, surgical or drug history etc., and laboratory parameters including complete blood count, Random Blood Sugar (RBS), chest x-ray, renal and liver function test, C-reactive protein, Lactate Dehydrogenase (LDH), serum ferritin, troponin I etc. Data were statistically analysed by unpaired t-test for continuous variables and chi-square test was used for comparing proportions. Results: Out of a total 2262 study subjects, 2066 (91.34%) were discharged from the hospital after recovery and 196 (8.66%) had expired. The various parameters contributing significantly to mortality were male gender, age >60 years, various co-morbid conditions like diabetes mellitus, hypertension and cardiac illness. The laboratory parameters observed to be significantly associated with mortality were thrombocytopenia, leucocytosis, hyperglycaemia, raised value of lactate dehydrogenase, creatinine, D-dimer, ferritin, C-reactive protein. Radiological findings including ground glass opacities and pleural effusion also were more common in the non survivor group as compared to the survivor group. Conclusion: More than half of the deceased patients were older than 60 years of age. The prevalence of co-morbidities and mean level of laboratory parameters were significantly high among non survivors as compared to those who recovered.","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":"71271311","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}

{"title":"Clinico-histopathological Features of Pyoderma Gangrenosum: A Case Series","authors":"M. Patel, Digisha Hamirbhai Jotva, N. Dhinoja, R. Patel, Neela M. Patel","doi":"10.7860/njlm/2022/51918.2575","DOIUrl":"https://doi.org/10.7860/njlm/2022/51918.2575","url":null,"abstract":"Pyoderma Gangrenosum (PG) is a rare, ulcerative, non infectious neutrophilic inflammatory dermatosis and often associated with underlying systemic disorder. The incidence of PG is estimated to be 0.63 per 1,00,000 with the median age at presentation of 59 years. Among its clinical variants, classical PG is the most common. The diagnosis of PG can be difficult. This case series was an attempt to review the new trends for the diagnosis of PG and also to compare them with previous diagnostic criteria. Previously histopathological criteria were included as minor criteria in Su WP et al., classification. More recently proposed diagnostic criteria by Maverkis E et al., include histopathology of skin biopsy from edge of ulcer showing neutrophilic infiltration as a major criteria. Aim of the study is to correlate and stamp the clinically suspected cases of PG with help of histopathology. This retrospective observational case series study was conducted in a tertiary care hospital from May 2018 to April 2020 consisting of 19 cases (15 years to 68 years of age range; 13 males and 6 females). Detailed history, clinical examination and blood investigations were done in all suspected cases of PG followed by histopathological examination of skin biopsy. In 17 cases, lesions were located in lower limb, one case each in buttocks and lower abdomen. The classical, ulcerative form found in 12 cases (63.15%), vegetative form in 3 cases (15.78%), plaque and bullae form were in 2 cases each (10.52%). Pathergy test was positive in 11 cases (57.89%). Histopathological examination showed neutrophilic infiltration in all 19 cases (100%), vasculitis in 11 patients (57.89%), lymphoplasmacytic infiltrate in 6 patients (31.57%), pseudoepitheliomatous hyperplasia in 5 patients (26.31%), mixed inflammatory infiltrate in 4 patients (21%), Epidermal ulceration in 4 patients (21%) and mitosis is seen in 3 patients (15.78%). Histopathology is considered as a main tool which helps clinicians to stamp suspected cases of PG.","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":"71270292","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}

{"title":"Categorisation of Salivary Lesions According to the Novel Milan’s System of Reporting Salivary Gland Cytopathology: A Retro-prospective Study","authors":"Nabila Afsar, P. Chinnathambi, G. Krishnakanth","doi":"10.7860/njlm/2022/52986.2590","DOIUrl":"https://doi.org/10.7860/njlm/2022/52986.2590","url":null,"abstract":"Introduction: Fine Needle Aspiration Cytology (FNAC) is an important diagnostic tool for salivary lesions, which has decreased the number of unnecessary invasive surgeries for benign conditions. But, cytopathology of salivary lesions is complex presenting with similarity in cytological features albeit with histological heterogeneity. The novel Milan’s System for Reporting Salivary Gland Cytopathology (MSRSGC) is a six tiered classification, providing standard reporting terminology for salivary gland lesions in fine needle aspirates. Aim: To categorise the salivary lesions cytologically based on MSRSGC and to assess its utility in simplification of routine diagnosis of salivary gland lesions. Materials and Methods: A retroprospective study was conducted in a tertiary care centre over a period of five years from 2017 to 2021. All patients suspected to have salivary gland lesions were subjected to FNAC in the Department of Cytology. The cases were reported according to the MSRSGC criteria and assigned one of the categories. The statistical analysis was performed using Microsoft excel software, for calculation of descriptive statistical parameters such as measures of central tendency viz., mean, median, mode, percentage, range and ratio. Results: A sample size of 82 patients with salivary gland lesions was studied. Parotid gland was most commonly involved, among others. Most of the lesions were classified as category 4a (Neoplasm benign) (39%) and category 2 (Non neoplastic) (36.6%). Non Diagnostic (ND) constituted only 2.43% while malignancies constituted 4.9%. Ambiguous categories like Salivary gland neoplasm of Uncertain Malignant Potential (SUMP) and suspicious of malignancy constituted 13.4% and 3.6%, respectively. Conclusion: The introduction of MSRSGC has to a large extent standardised the reporting patterns, thereby assisting the clinicians to render improved patient care. The present study in comparison with other studies conducted worldwide, recommends the usage of MSRSGC for routine reporting.","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":"71270691","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}

{"title":"Comparison of Sodium and Potassium by Point-of-Care Arterial Blood Gas Analyzer and Venous Serum by Central Laboratory Analyser in Emergency Clinical Decision Making","authors":"Valiyaveetil Anjana, K. T. Madavan","doi":"10.7860/njlm/2022/53252.2646","DOIUrl":"https://doi.org/10.7860/njlm/2022/53252.2646","url":null,"abstract":"Introduction: The Emergency Departments (ED) are equipped with Point-of-Care (POC) blood gas analysers (BGA) which deliver fast results on multiple parameters of arterial/venous blood. There is no consensus among ED physicians on the reliability of electrolyte results by POC Arterial Blood Gas (ABG) analysis compared to venous serum electrolyte from Central Laboratory Analyser/Auto-Analyser (CLA/AA). Aim: To compare the electrolyte(sodium and potassium) by POC arterial BGA (ABL800 Flex Radiometer) with venous electrolyte by CLA (Beckman Coulter AU 5800). Materials and Methods: This cross-sectional study was performed in the ED and Central Laboratory of the tertiary hospital from 1st July 2018 to 31st July 2019. A total of 254 critically ill adult patients with various etiologies, were enrolled in the study. The arterial and venous blood samples were collected for electrolyte measurement within a span of 15 minutes. The ABG samples, anticoagulated with liquid heparin, were processed in POC BGA. The venous samples collected in plain tubes were analysed in CLA. The results of sodium and potassium were compared by the mean, correlation coefficient, p-value, and Bland Altman Plots {95% Limit of agreement (LOA)}. Results: Out of 254 paired samples (mean age: 63±15 years), 157 (61.8%) were males and 97 (38.2%) females. The mean sodium values were 131.9±7.7 mmol/L in ABG and 132.3±7.1 mmol/L in CLA (p-value <0.0001). The mean difference was 0.4 mmol/L. The mean potassium values were 3.9±1.0 mmol/L (ABG) and 4.2±0.9 mmol/L (CLA), {p-value<0.0001}. The mean difference was 0.3 mmol/L. These differences were within the accepted range specified by the United States Clinical Laboratory Improvement Amendments. There were statistically significant strong positive correlations between the measurements of the two instruments r=0.78 for sodium and r=0.76 for potassium. The 95% LOA for sodium and potassium on both the instruments were -10.03 to 9.09 mmol/L and -1.49 to 0.97 mmol/L respectively, both wide and unacceptable. Conclusion: The arterial sodium and potassium measurements by BGA were not reliable in decision making in ED when compared to the venous serum by CLA as the 95% LOA was wide and unacceptable. Hence, sodium and potassium values by BGA alone might not be used as criteria for management without confirmation from venous serum values by CLA.","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":"71271027","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}

{"title":"Early Detection of Drug Resistant Enterobacteriaceae in Urinary Tract Infections using Chromogenic Agar Medium in a Tertiary Care Hospital, Kakinada, Andhra Pradesh, India","authors":"N. Reddi, Sobharani Sanapala, Radhika Budumuru","doi":"10.7860/njlm/2022/59117.2678","DOIUrl":"https://doi.org/10.7860/njlm/2022/59117.2678","url":null,"abstract":"Introduction: The irrational and inappropriate use of beta lactam antimicrobial drugs has led to the advent of Extended Spectrum Beta-Lactamase (ESBL) resistant strains. ESBL producing Enterobacteriaceae strains are frequent causative agents both in community and in acquired nosocomial infections and Urinary Tract Infections (UTI). The phenotypic confirmatory tests rarely identify all ESBLs. Chrom ID (Chromogenic identification Media) ESBL – Bx (bioMerieux) is a completely new and innovative chromogenic medium designed specifically for the screening of ESBL producing Enterobacteria directly from urine samples. It is a ready to use selective media which is sensitive and specific for rapid and presumptive identification of ESBL producing Enterobacteriaceae. Aim: Early detection of ESBL producing Enterobacteriaceae directly from urine samples on chromogenic medium (Chrom ID- ESBL- Bx) and confirmation of ESBL producing Enterobacteria using Disc Potentiation Test (DPT). Materials and Methods: The present cross-sectional study was conducted in the Department of Microbiology, Rangaraya Medical College, Kakinada, Andhra Pradesh, India from November 2019 to March 2020 (five months duration). The study was done on 70 urine samples from patients with UTI. All samples were subjected to wet mount, inoculated directly for culture on Chrom ID ESBL- Bx agar and MacConkey agar. Antibiotic Susceptibility testing of ceftazidime and cefotaxime was done by Kirby-Bauer disc diffusion method and conformation of ESBL production by DPT using Clinical and Laboratory Standards Institute (CLSI) method. The Statistical Package for the Social Sciences (SPSS) Statistical package version (18.0) was used. Results: A total of 56 (80%) isolates were obtained from 70 urine samples, out of them 28 (50%) were Escherichia coli, 21 (37.5%) were Klebsiella spp., 7 (12.5%) were Proteus spp., 23 (82.14%) isolates of Escherichia coli, 15 (71.43%) of Klebsiella spp., 6 (85.71%) of Proteus spp., isolated were screened positive using Chrom ID ESBL-Bx agar. About 44 (78.57%) of total Enterobacteria (56) were screened for ESBL production. 20 (86.96%) of Escherichia coli, 11 (73.33%) of Klebsiella spp., and 5 (83.33%) of Proteus spp., that were screened positive using Chrom ID ESBL agar were confirmed (by DPT) as ESBL producers and 2 (16.6%) of total (12) isolates that were screened negative by Chrom ID ESBL agar were confirmed as ESBL producers when screened and confirmed by DPT. So sensitivity and specificity CHRO Magar was 94.73% and 55.5%. Conclusion: ESBL continues to become a serious public health threat. Results from present study showed that CHROMagar ESBL has a high sensitivity and a convenient method for making provisional diagnosis of drug resistant Enterobacterial infections in 24 hours. Chrom ID ESBL- Bx agar medium allows easy differentiation of different bacteria based on colony colouration.","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":"71271369","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}

{"title":"Effect of Hypothyroidism on Menstrual Cycle Pattern and Fertility at a Tertiary Care Centre in South India","authors":"Byndoor Yatish, Kamal Kachhawa, Tamilisetti Vidya Sagar, Sanjay Kumar, B. Rath, S. Mahapatra","doi":"10.7860/njlm/2022/55936.2679","DOIUrl":"https://doi.org/10.7860/njlm/2022/55936.2679","url":null,"abstract":"Introduction: Thyroid disorders are very common in females and are known to prevent ovulation. Thyroid disorders can impact menstrual cycles and causes menstrual irregularities and infertility in females. Aim: To determine effects of hypothyroidism on menstrual cycle pattern and prevalence of subfertility among women having thyroid dysfunction. Materials and Methods: This cross-sectional study was conducted in Department of Obstetrics and Gynaecology in collaboration with Department of Endocrinology in Government Medical College, Datia Madhya Pradesh, India from July 2019 to June 2021. A total of 205 patients aged 18-45 years were taken. Among them, 116 and 89 patients were of hypothyroid and euthyroid respectively. After properly selecting patients, detailed history of their menstrual cycles was taken and effect of thyroid dysfunction on menstrual irregularities was assessed. The collected data were evaluated and analyzed using Statistical Package of the Social Sciences (SPSS). Results: A total of 205 patients participated in present study. Mean age was 35+/-5 years. Among 205 subjects, 116 were hypothyroid and 89 were euthyroid. Among the hypothyroid subjects, 72 (62.1%) had normal menstrual cycles, 23 (19.8%) had history of oligomenorrhea, 12 (10.3%) had polymenorrhea, and 9 (7.7%) had amenorrhea, while among the thyroid subjects, 76 (85.4%) had normal menstrual cycle, 6 (6.7%) had oligomenorrhea, 5 (5.6%) had polymenorrhea, and 2 (2.2%) had amenorrhea, with statistically significant differences (p<0.001). The proportions of primary 13 (11.2%) and secondary 9 (7.7%) subfertility were significantly higher among hypothyroid subjects compared with thyroid subjects (p<0.05). The prevalence of subfertility was 7 (7.8%), 10 (14.28%), and 12 (26.08%) among the thyroid, overtly hypothyroid, and subclinical hypothyroid subjects, respectively. Conclusion: In this study, effects of thyroid dysfunction were presumably significant on menstrual cycle pattern and fertility; therefore, thyroid status should be assessed in all patients with menstrual disorders and appropriate treatment should be initiated early.","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":"71271397","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}