Evaluation of diagnostic accuracy of different biomarkers for prostate cancer

Objective: Serum total prostate specific antigen (PSA), free fraction of total prostate specific antigen percent (fPSA %) and prostate specific antigen density (PSAD) have all been considered as valuable non-invasive tumor markers for prostate cancer. This study was carried out to evaluate and compare the performances of serum total PSA, fPSA% and PSAD in terms of their sensitivity, specificity and overall diagnostic accuracy for prostate cancer. Methodology: Fifty (50) DRE (digital rectal examination)-positive patients admitted in Rajshahi Medical College Hospital (RMCH), Bangladesh during January, 2006 to January, 2008 were included. Estimation of serum total PSA and fPSA% were done by ELISA (Enzyme linked immunosorbent assay) using commercially available kits. Data pertaining to volume of prostate as determined by transabdominal ultrasonography were used to calculate PSAD and histology of the surgically resected prostatic tissue was done for laboratory confirmation of prostate cancer for all patients. Diagnostic sensitivity, specificity and accuracy of serum total PSA, fPSA% and PSAD were calculated using standard formulae against histopathological diagnosis. Results: Prostate cancer was revealed in 41 of 50 patients by histopathological examination with mean age of 71.2 ±10.1 years. There were 9 cases detected as Nodular Hyperplasia of Prostate (NHP) with prostate-specific biomarkers mostly within their normal range. The sensitivity, specificity and overall diagnostic accuracy for prostate cancer of serum total PSA (at cut off value of >10 ng/ml) were 80.48%, 88.90% and 82.00%, for serum fPSA (at cut off value of 0.15 ng/ml/cm3), were found to be 90.00%, 88.90% and 90.00% respectively. Histologically, 27 (65.85%), 13 (31.71%) and 01 (2.44%) cases were labeled as poorly diffentiated, moderately differentiated and well differentiated carcinoma respectively and overwhelming majority had excellent correlation with all prostate-specific biomarkers. Conclusion: These results reinforce that different prostate-specific biomarkers have good diagnostic prediction with free PSA percent and PSAD have slightly better diagnostic accuracy over serum total PSA for prostate cancer

Free PSA is a better tumor marker than serum total PSA in diagnosis of prostatic carcinoma

Estimation of serum prostate specific antigen (PSA) has been considered as valuable non-invasive biochemical diagnostic tool for early detection of prostatic carcinoma. This cross sectional purposive study was carried out to compare the performance of serum total PSA and free PSA in terms of their sensitivity, specificity and overall diagnostic accuracy for prostatic carcinoma among clinically suspected cases. This study included a total of fifty (50) DRE (digital rectal examination) positive patients admitted in Rajshahi Medical College Hospital (RMCH) and Private hospitals in Rajshahi city during the period of January, 2006 to January, 2008. Estimation of serum total PSA and free PSA were done by ELISA (Enzyme linked immunosorbent assay) method using commercially available kits and histopathological examination of the surgically resected prostatic tissue was done for laboratory confirmation of the diagnosis of prostatic carcinoma for all patients. Diagnostic sensitivities, specificities and overall accuracy of serum total PSA and free PSA were calculated using standard formulae against histopathological diagnosis. Prostatic carcinoma was detected by histopathological examination in 41 cases out of 50 patients with the mean age of 71.2 ± 10.1 years. The sensitivity, specificity and overall diagnostic accuracy of serum total PSA (at cut off value of ≥10 ng/ml) were found to be 80.48%, 88.90% and 82.00% respectively while they were 92.68%, 77.80% and 90.00% respectively for serum percent free PSA (at cut off value of ≤25%). It is inferred that percent free PSA is a better tumor marker than serum total PSA in the diagnosis of prostate carcinoma

Surgical site infection by Mycobacterium tuberculosis following caesarian section

Surgical site infection by M. tuberculosis is uncommon and its diagnosis can be missed unless there is strong clinical suspicion coupled with laboratory confirmation. We report a case of primary tuberculous surgical site infection without any evidence of pulmonary, skeletal or gastrointestinal tuberculosis in an immunocompetent patient, presented as non healing discharging wound following lower uterine caesarean section (LUCS). This is the first case report of its kind from Bangladesh to the best of our knowledge. The case was diagnosed by detection of acid fast bacilli (AFB) in pus by Ziehl Neelsen staining and histological evidence of granulomatous lesion compatible with tuberculosis found in surgically excised granulation tissue. The patient was treated with 4 anti-tubercular drugs regimen for initial two months and responded well showing complete healing of her wound. The case is being reported primarily for its unusual site and rarity as Mycobacterial infection

In vivo analysis of toxic effect of hydrose used in food preparations in Bangladesh

Objective: To evaluate the toxic effect of hydrose used in the molasses preparation in Bangladesh. Methods: Molasses were collected from open markets in different parts of Bangladesh. The presence of hydrose in selected molasses was detected using commercial kit. To evaluate the toxic effect of hydrose, Swiss albino male mice were divided into four groups. Group I was used as control, while Groups II, III and IV received hydrose mixing food (5, 10 and 25 g/kg food), respectively, and these supplementations were continued to the end of the study (16 weeks). Blood was collected from thoracic arteries of the mice under ether anesthesia and then organs were taken. To determine the effect of hydrose on host, blood indices related to liver, heart and kidney dysfunctions were measured. Results: Creatinine and urea levels were significantly (P<0.05) increased in a dose dependent manner in hydrose treated mice, whereas calcium level was significantly decreased in hydrose exposed mice compared to control mice. Histological study of kidney showed the glomeruler inflammation, increased diameter of renal glomeruli and enlargement of proximal tubular lumen of kidneys of mice exposed to hydrose compared to that of control animals. Conclusions: The results of this study indicated that use of hydrose in molasses and other food preparations in Bangladesh may cause kidney impairment