Bacteriological Spectrum and Sensitivity Pattern in Culture Proven Urinary Tract Infection in Children

To determine the different types of organisms causing urinary tract infections in children and their sensitivity to antibiotics.Methods: This cross sectional study was conducted at Children Hospital, PIMS Islamabad and consisted of 117 patients of either gender between age of 03 months to 12 years.Results: Mean age of children enrolled in our study was 4.4 (± 2.6) years. Out of 117 patients, 63 (54 %) were girls. The most common isolate was E. coli (57.3%) percent, followed by Klebsiella (18.8 %), Staphylococcus aureus (13.7 %), Pseudomonas (5.1 %) and Proteus (3.4 %) children. All isolates were sensitive to ciprofloxacin, of loxacin, amikacin, cefixime and imepenem. Only 38.5% E coli and 37.5% Klebsiella were sensitive to Ampicillin, and 14.3% E coli and 9.1% Klebsiella were sensitive to Trimethoprim-sulphamethoxazole.Conclusion: The most common isolate was E. coli, followed by Klebsiella, Staphylococcus aureus, Pseudomonas and Proteus. Most antibiotics tested for the E. coli, Klebsiella, Staphylococcus, Pseudomonas and Proteus are effective except Cotrimoxazole, Ampicillin, and Gentamicin which show high resistanc

Evaluation for Granulomatous Inflammation on Fine Needle Aspiration Cytology Using Special Stains

Background. Tuberculosis is the commonest infectious disease in the developing world. Many diagnostic tests are devised for its detection including direct smear examination. This study was designed to determine the frequency of cases positive for AFB and positive for fungus in patients diagnosed to have granulomatous inflammation on Fine Needle Aspiration Cytology using special stains. Materials and Methods. A descriptive cross-sectional survey was done on 100 cases of granulomatous inflammation consistent with tuberculosis diagnosed on fine needle aspiration cytology at the Department of Pathology, King Edward Medical University, Lahore. After reporting granulomatous inflammation on Hematoxylin & Eosin staining of aspirates from FNAC, some unstained slides were subjected to special stains, like ZN, GMS, and PAS. Cases positive for AFB on ZN stain and fungus on GMS/PAS were noted down along with their frequency and percentages. Results. Forty-four cases (44%) of AFB positive smears were reported in granulomatous inflammation while only 5% cases of fungus were reported down. Cervical lymph nodes were the most commonly involved site (87%), and females were affected more (62%) than males. Most cases of AFB-positive smears were associated with caseation necrosis (93%). Conclusion. Special stains should be done on all granulomatous inflammation cases seen on FNAC for confirmation of TB and ruling out other infectious causes

Differential Diagnosis of Osteogenic Tumors in the Context of Osteosarcoma

Primary bone tumors are rare, but osteosarcoma (OS) is the fourth commonest non-hematological primary neoplasm of the bone in the adolescence, and the other three commonest neoplasms, in descending order, are leukemia, brain tumors, and lymphoma. The commonest presenting complaints are swelling and aches. These tumors cannot be diagnosed without the help of radiology. There is a wide age range of these neoplasms commonly appearing in the second and third decade of life with a peak incidence in early teens. Males are affected more than females. The exact cause of osteosarcoma is unknown. However, a number of risk factors, like genetic predisposition, some existing bone diseases, environmental risk factors, and radiations, have been identified. If the bone tumors are viewed by clinical, radiological, and histopathological perspectives, the correct diagnosis can be made easily. Chemotherapy combined with surgery is the standard treatment modality with better 5-year survival rates. Elevated AKP is an important prognostic factor in this malignancy

Comparison of Fine Needle Aspiration Cytology and Thyroid Scan in Solitary Thyroid Nodule

Objective. This was a comparative study between FNAC and thyroid scan used to diagnose the solitary thyroid nodule and histopathology was used as gold standard to compare the results of both modalities. We hypothesized that Fine needle aspiration cytology and thyroid scan diagnose solitary thyroid nodule (STN) as accurately as histopathology. Materials and Methods. This study comprised of 50 patients with solitary thyroid nodules (STN) presented to OPD. After clinical examination these patients were referred to Centre for Nuclear Medicine, Mayo Hospital Lahore for thyroid function tests and thyroid scan (TS). These patients underwent FNAC in the department of Pathology and surgery in Mayo Hospital. The cases were operated and evaluated for histopathological changes. Results. On thyroid scan, 40 patients (80%) having cold nodule were labeled as suspicious 10 patients (20%) had hot nodule. On FNAC 23 patients (46%) had benign lesion, 22 patients (44%) had indeterminate lesion and 5 patients (10%) had malignant lesions. On histopathology, 45 patients (90%) were confirmed to have benign lesions and 5 patients (10%), malignant lesions. After comparison of results of thyroid scan and FNAC with histopathology, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of thyroid scan were 80%, 20%, 10%, 90% and 26%, respectively whereas those of FNAC were 80%, 97.7%, 80%, 97.7% and 96%, respectively. Conclusion. Fine needle aspiration was a significantly better predictor of malignancy than thyroid scan and resulted in a smaller proportion of excisions for benign nodules

Identification of genetic variants associated with a wide spectrum of phenotypes clinically diagnosed as Sanfilippo and Morquio syndromes using whole genome sequencing

Mucopolysaccharidoses (MPSs) are inherited lysosomal storage disorders (LSDs). MPSs are caused by excessive accumulation of mucopolysaccharides due to missing or deficiency of enzymes required for the degradation of specific macromolecules. MPS I-IV, MPS VI, MPS VII, and MPS IX are sub-types of mucopolysaccharidoses. Among these, MPS III (also known as Sanfilippo) and MPS IV (Morquio) syndromes are lethal and prevalent sub-types. This study aimed to identify causal genetic variants in cases of MPS III and MPS IV and characterize genotype-phenotype relations in Pakistan. We performed clinical, biochemical and genetic analysis using Whole Genome Sequencing (WGS) in 14 Pakistani families affected with MPS III or MPS IV. Patients were classified into MPS III by history of aggressive behaviors, dementia, clear cornea and into MPS IV by short trunk, short stature, reversed ratio of upper segment to lower segment with a short upper segment. Data analysis and variant selections were made based on segregation analysis, examination of known MPS III and MPS IV genes, gene function, gene expression, the pathogenicity of variants based on ACMG guidelines and in silico analysis. In total, 58 individuals from 14 families were included in the present study. Six families were clinically diagnosed with MPS III and eight families with MPS IV. WGS revealed variants in MPS-associated genes including NAGLU, SGSH, GALNS, GNPTG as well as the genes VWA3B, BTD, and GNPTG which have not previously associated with MPS. One family had causal variants in both GALNS and BTD. Accurate and early diagnosis of MPS in children represents a helpful step for designing therapeutic strategies to protect different organs from permanent damage. In addition, pre-natal screening and identification of genetic etiology will facilitate genetic counselling of the affected families. Identification of novel causal MPS genes might help identifying new targeted therapies to treat LSDs

Is Omicron a Tsunami? What should be the strategy to prevent the loss?

The COVID-19 pandemic began in December 2019 with the 5th wave setting in from January 2022. Every wave was due to the emergence of a new variant of the virus. The first wave was caused by the Wuhan Virus from 26th February- September 2020, second wave lasted from 28th Oct 2020 to February 2021 whereas the third wave or UK variant emerged from our neighbouring country India. Corona first and second wave in Pakistan, and strategies The 1st and 2nd waves were associated with a low death rate. It was well controlled due to being timely managed by the Government. It was short lived as the case and death rates began to recede rapidly after peaking. The management policies of smart and partial lockdowns proved successful by curbing the transmission of the disease. The same strategies were adopted in the second wave. The first wave claimed 6795 lives, infected 332,186, left behind 632 on ventilators. During the 2nd wave, there were 579,973 infected and 12,860 died till 28th February 2021. Continues..