Introduction and objective: Approximately 1 in 3 women will require antimicrobial
treatment for a Urinary Tract Infection (UTI) before age 24, and 40% to 50% of women will
have a UTI during their lifetime. UTIs in male patients are considered complicated.
Escherichia coli is the most common cause of UTIs.
Materials and methods: In the present study 7056 patients with clinical symptoms and
suspected to UTI were sampled. Clean-Catch midstream urine of the patients was collected.
Urine specimens were cultured for isolation of the microbial agents of UTI. The isolated
bacteria were identified using biochemical tests. Disk diffusion susceptibility test was used
to determine susceptibility of bacterial agents to antibiotics.
Results: In this study 553(8.7%) patients out of 7056 were shown to be urine culture
positive (68% females and 32% males). The most isolated bacterium was E. coli with
frequency rate of 59%. The other bacteria were Klebsiella spp. (11.6%), Enterobacter spp.
(9.8%), Pseudomonas spp. (7.2 %), Proteus spp. (2.9%), Acinetobacter spp. (2.7%),
Congolese positive Staphylococci (2.2%), Coagolase negative Staphylococci (2.3%),
Citrobacter spp. (1.3%) and Streptococci α hemolytic (1.1%). All Gram-negative bacteria
were more sensitive to amikacin (90.5-100%). The Gram-positive cocci isolated were more
sensitive to tobramycin, kanamycin and ciprofloxacin (100%).
Conclusion: It is concluded that Gram-negative bacilli were responsible for UTI infections
in our patients. The most common isolated bacteria from urinary tract infections were E. coli
and the most effective antimicrobial agents were amikacin, tobramicin and ciprofleoxacin
against Gram-negative bacilli and also the most effective antibiotics against Gram-positive
cocci were kanamicin, tobramicin and ciprofleoxacin.

Study of bacteria isolated from urinary tract infections and determinationof their susceptibility to antibiotics

Background: AUB is one of the most common problems in women of all ages especially those in the peri-menopausal age group. The abnormal bleeding can be caused by a wide variety of disorders and it is one of the commonest complaints leading to endometrial sampling. Objectives: Our study aimed at determining the types and frequencies of endometrial pathologies in patients presenting with abnormal uterine bleeding at our hospital which caters largely to women of low socioeconomic status. Material and Methods: The present study was conducted at the Hakeem Abdul Hameed Centenary Hospital, New Delhi. This was a retrospective age specific comparative analysis of 638 women presenting with abnormal uterine bleeding, who underwent endometrial sampling at our hospital. The pattern of endometrial histopathological changes were identified and classified. Results: Age of the patients ranged from 15 to 70 years, maximum patients (35.89 %) in the age group 41-50 years. The most common clinical presentation was represented by menorrhagia (41%) Various patterns on histopathology were secretory endometrium(28.99%)the commonest, followed by proliferative endometrium (24.92%). Incidence of malignancy was low in the present study. Conclusion: Endometrial curetting and biopsy is an important diagnostic procedure in evaluation of AUB.. Endometrial causes of AUB are age related, therefore it is specially recommended in women of the perimenopausal age presenting with AUB, to rule out preneoplasia and malignancy.

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Atypical uterine bleeding-Histopathological audit of endometrium A study of 638 cases

Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

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Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.

Dysfunctional uterine bleeding (DUB) is a clinical term used to describe bleeding not attributable to any underlying organic pathological condition. A total of 187 patients were included in the present study which were categorized in reproductive ( 50yrs) age groups. One hundred sixteen cases (62%) were in reproductive age group, 47 cases (25.1%) in perimenopausa l age group and 24 cases (12.8%) in postmenopausa l age group. Histopathological examination of dilatation and curettage (D&C) samples was done to elucidate the cause of DUB. In reproductive age group, proliferative endometrium was the most common finding (26.8%) followed by irregular maturation (25%).Complex hyperplasia was seen in 6 cases, out of which 1 case showed atypia. Nineteen cases (16.4%) showed associated endometritis. No case of malignancy was observed in this group. In perimenopausal age group, simple hyperplasia was the most frequent finding (29.8%).Complex hyperplasia was seen in 3 cases, out of which 1 revealed atypia. Three cases of malignancy (6.4%) were reported. In postmenopausal age group, most frequent finding in DUB was complex hyperplasia seen in 8 cases (33.3%), out of which 2 cases showed atypia. Six cases (25%) of simple hyperplasia and 4 cases (16.7%) of malignancy were reported. Atrophic endometrium was observed in D&C samples from 6 patients (25%).

Morphological Spectrum of Endometrium in Patients Presenting with Dysfunc- tional Uterine Bleeding

Background: Abnormal uterine bleeding (AUB) is a common gynecological complaint associated with considerable morbidity and significantly affects the patient's family, personal and social life. The aim of the study was to analyze the histomorphological patterns of endometrium in patients presenting with AUB and also to determine the incidence of AUB in various age groups. Materials and Methods: This is a prospective study, conducted in the Department of Pathology, in a tertiary care teaching hospital, Mangalore from October 2011 till date. All cases of AUB with a probable endometrial cause were included in the study. Data was entered in Microsoft Excel and managed in Statistical Package for the Social Sciences (SPSS) version 16. Analysis was done in the form of percentages and proportions and represented as tables where necessary. Results: A total of 156 cases were analyzed. Patients' age ranged from 23-78 years. AUB was most prevalent in the perimenopausal age group. The most common presenting complaint was menorrhagia (47%). Endometrial hyperplasia was the most common histopathological finding and was seen in 25% patients, followed by secretory endometrium in 16.7% patients, and proliferative phase pattern and disordered proliferative endometrium were seen in 12.2% patients each. Malignancy was detected in 6.4% of cases and endometrial carcinoma was the most common lesion (4.5%). Conclusions: Histopathological evaluation of endometrial samples is especially indicated in women over the age of 35 years to rule out malignancy and preneoplasia. Among the patients with no organic pathology, normal physiological patterns with proliferative, secretory, and menstrual changes were observed. The most common endometrial pathology in this series was endometrial hyperplasia.

Study of histopathological patterns of endometrium in abnormal uterine bleeding

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16

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Histopathological pattern of endometrial samples in abnormal uterine bleeding

Results: Out of 57 cases of bone marrow aspiration, erythroid hyperplasia was seen in 12 cases (21%). Megaloblastic anemia was seen in 7 cases (12.3%) and microcytic anemia was seen in 4 cases (7%). There were 6 cases (10.5%) of Idiopathic Thrombocypenic Purpura. Acute leukemia was diagnosed in 7 cases (12.3%) and among this acute myeloid leukemia (10.5%) was more common than acute lymphoid leukemia (1.8%). Myelodysplastic syndrome and multiple myeloma was seen in 3.5 % cases each. Aplastic anemia and kalaazar was seen in 5.3% and 1.8% cases respectively.

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Interpretation of bone marrow aspiration in hematological disorder

Urothelial carcinoma is the most common tumor of the bladder and is a major cause of morbidity and mortality. Cystitis constitutes an important source of clinical signs and symptoms. In this study 31 cystoscopic biopsies subjected for histopathological examination were taken. The study was conducted in the department of Pathology of Nepal Medial College Teaching Hospital over a period of two years (October 2012 to September 2014). The mean age of the patient undergoing cystoscopic biopsy was 61.3 years, most of the patients being elderly male. 51.6% cases were clinically malignant. The most common histopathological diagnoses were cystitis (29%) and non invasive papillary urothelial carcinoma, low grade (29%). 58% are neoplastic lesions. 51.6% of the case was malignant lesions on histopathology. Among the malignant lesion of urinary bladder 93.7% were urothelial tumor and 6.3% were glandular neoplasm (adenocarcinoma, signet ring cell). There was no detrusor muscle in 33.3% cases of urothelial tumor to assess the muscle invasion. 26.7% cases of urothelial tumor shows muscle invasion. Histopathological study of cystoscopic biopsy helps in early detection of tumor and its management.

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Cystoscopic bladder biopsies: a histopathological study.

Background: Urinary tract infection is one of the common bacterial infections seeking treatment in clinical practice. A variety of organisms are associated with UTI and the most common organisms are Escherichia coli and other coliforms. Bacteriological investigations of UTI are not complete without antibiotic sensitivity test of the isolate. The aim of this study is to determine the bacteriological profile and antibiotic sensitivity patterns and their disease association. Materials and methods: This study was conducted in Shankarapur Hospital over a period of one year. All cases of suspected UTI sent for urine culture and sensitivity test were evaluated in this study. Disease associated with UTI, bacteriological profile and antibiotic sensitivity patterns were evaluated. Results: A total of 974 cases were sent for urine culture and sensitivity test. The total culture positive cases were 165 (17.4%).  The most common age group for culture positive test was 21- 30 years (33.3%) followed by 31- 40 years (25.5%). Female patients formed the majority of culture positive cases (84.8%) and E Coli (86.1%) was the most common organism isolated. Piperacillin- tazobactum and ceftriaxone were the most common antibiotic sensitive to the organisms. Simple uncomplicated UTI and PID were the most common indication for subjecting the patients to urine culture. Conclusion: UTI is most commonly seen in female of reproductive age group and the most common causative organism is E coli. Culture result and antibiogram helps the clinician for specific treatment of UTI.

/pdf/bacteriological-profile-and-antibiotic-sensitivity-pattern-2sec3rw132.pdf

Bacteriological profile and antibiotic sensitivity pattern in patients with Urinary tract infection

Background: Development of lesions in the oral cavity is strongly linked with smoking and alcohol consumption. Non neoplastic lesions are mainly inflammatory conditions. It has been seen that the benign lesions are more common than malignant. Materials and methods: This was a retrospective study carried out in the Department of Histopathology of Helping Hands Community Hospital during a period of one and a half years from January 2009 to June 2010. The study included 21 cases of oral cavity lesions. Results: The most common site was lip with 9 cases (42.8%) followed by buccal cavity with 5 cases (23.8%). Out of the 21 cases of oral cavity lesions, 20 cases (95.2%) were benign and 1 case (4.8%) was malignant. The malignant lesion was a case of squamous cell carcinoma of soft palate. Conclusion: Any oral cavity lesion should have a tissue diagnosis for rational management of the case and to avoid mutilating surgery. Keywords: Oral cavity; Fibroma; Mucocele DOI: 10.3126/jpn.v1i1.4452 Journal of Pathology of Nepal (2011) Vol.1, 49-51

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S Pudasaini

Papers

Histopathological pattern of endometrial samples in abnormal uterine bleeding

Interpretation of bone marrow aspiration in hematological disorder

Cystoscopic bladder biopsies: a histopathological study.

Bacteriological profile and antibiotic sensitivity pattern in patients with Urinary tract infection

Oral cavity lesions: A study of 21 cases