Bangladesh Journal of Pathology

Role of Light Emitting Diode (LED) Fluorescence Microscopy in the Diagnosis of Smear Negative Pulmonary Tuberculosis.

2011-12-09T01:17:04+00:00

Light emitting diode (LED) fluorescence microscopy offers well described benefits compared with brightfield microscopy by Ziehl-Neelsen stained sputum, even which are smear negative. We evaluated the diagnostic performance of fluorescence microscopy, using novel light-emitting diode (LED) technology as an alternative to the brightfield microscopy. The objective of this study was the role of LED fluorescence microscopy in diagnosis of smear negative pulmonary tUberculosis. This is a prospective study consisted of 50 smear negative patients, who were clinically suspected cases of pulmonary tuberculosis. All samples were stained by both ZN stain and Auramine stain and as a gold standard all were cultured on Lowenstein-Jensen Media. On evaluation of all sputum samples were found negative by ZN method but by auramine stain 16%, 20%, 20% cases were found positive by conventional fluorescence microscopy (CFM), LED and culture respectively. LED fluorescence microscopy is more useful test to distinguish the smear negative cases. It also provide an effective guideline to make decisions regarding judicious use of antitubercular drug therapy.

Keywords: Smear negative Sputum; LED; CFM; Culture; Pulmonary Tuberculosis

DOI: http://dx.doi.org/10.3329/bjpath.v26i1.9126

BJPATH 2011; 26(1): 3-6

Current status of MRSA and its Resistance to Ciprofloxacin in an Urban Hospital in Dhaka City

2011-12-09T01:17:04+00:00

DOI: http://dx.doi.org/10.3329/bjpath.v26i1.9127

BJPATH 2011; 26(1): 7-10

Haematopoietic Recovery On Induction Therapy In Acute Lymphoblastic Leukaemia By Automated Reticulocyte Analysis

2011-12-09T01:17:04+00:00

Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy in Bangladesh. ALL is treated with chemotherapy due to high responsiveness. After chemotherapy infection may occur which increases the time of aplasia. For this purpose, reliable laboratory tests that will indicate early haematological recovery are needed. At present, absolute neutrophil count (ANC), reticulocyte counts and peripheral blood film (PBF) examination are used after chemotherapy for prediction of bone marrow recovery. Reticulocyte quantification in the peripheral blood samples, as a percentage or absolute count with immature reticulocyte fraction (lRF) are a reliable measure of haematological recovery established by many studies. This cross sectional study was carried out to evaluate the haematopoietic recovery in children with ALL by automated reticulocyte analysis. Total fifty patients were enrolled in this study on remission induction phase. They received the drugs of the protocol of UKALL-XI. All patients were between 8 months to 15 years age range with a mean age of 5.5 ±3.2. In this study the recovery of reticulocyte percentage occurred at a median of 20 days; ARC 18 days; IRF 16 days; HFR 18 days and ANC was obtained after a median of 23 days. This study established that among the various parameters IRF recovered earlier than others.

Keywords: Immature Reticulocyte Fraction(lRF); High fluorescent reticulocyte (HFR); Low fluorescent reticulocyte (LFR); Middle fluorescent reticulocyte (MFR); Absolute neutrophil count (ANC); Absolute Reticulocyte count(ARC).

DOI: http://dx.doi.org/10.3329/bjpath.v26i1.9128

BJPATH 2011; 26(1): 10-13

Immune Deposits in Glomerular Diseases and Their Clinical, Histopathological and Immunopathological Correlation

2011-12-09T01:17:04+00:00

Glomerulonephritis (GN) is a common renal disease and common cause of chronic renal failure (CRF) accounts for more than one-third of patients of end stage renal disease (ESRD) requiring either dialysis or transplantation. In our country, early diagnosis and treatment of GN depends on routine urine and blood examination and using light and immunofluorescent microscopic study of renal biopsy. The purpose of this study was to demonstrate the frequency, type, intensity, pattern and site of deposition of immunoglobulin IgG, IgA, IgM and C3 by direct immunofluorescence microscopic technique (DIF) in various pattern of GN and to correlate with clinical and histopathological findings. Among 120 cases of renal biopsy, 110 cases (91.67%; n=120) were adequate for histopathologic study only and 98 cases (81.67%; n=120) were adequate for both histopathologic and direct immunofluorescence microscopic study. In this series, maximum numbers of cases were found in 21-30 age group (27.27%). Most frequent clinical presentation and pattern of glomerulonephritis were nephrotic syndrome (61.22%; n=98) and mesangioproliferative GN (40.81%) respectively. Among 98 cases of study group, 49 cases (50%; n=98) were DIF positive. The most frequent type of depositions were C3 (type) in various combinations (98%; n=49) followed by IgG (67.35%) and IgA (40%). Mesangium followed by glomerular basement membrane were the most frequent site and granular pattern was the most frequent pattern of deposition. The frequent combination of depositions in various pattern of GN were C3 + IgG (36.73%; n=49) followed by C3 + IgA (20.41%). There was a correlation between histopathologic pattern of GN and type-site-pattern of deposition in the glomeruli. Immune-depositions were cent percent in IgA nephropathy, membranous GN (MGN), diffuse proliferative GN and membranoproliferative GN. Among 15 cases of IgA neph.ropathy (15.31%; n=98), most frequent pattern and clinical presentation of GN was mesangioproliferative GN (60%; n=15) and haematuria (46.67; n=15) respectively. In this study, DIF was proved to be essential, sensitive and specific diagnostic tool in the evaluation of glomerular diseases. However, DIF study is no substitute of light microscopy but both provide information which when taken as a whole contributes to better understanding of GN.

Key words: DIF; GN; CRF; ESRD

DOI: http://dx.doi.org/10.3329/bjpath.v26i1.9129

BJPATH 2011; 26(1): 14-19