Category Archives: 16(4) Oct-Dec 2018

Diagnosis of Pulmonary Tuberculosis; Conventional Versus Fluorescent Microscopy and Gene Xpert MTB/RIF

Fatima Zahra, Aamer Ikram, Gohar Zaman , Luqman Satti, Farida Lalani and Maria Khan

Department of Microbiology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan



Tuberculosis is an infectious disease with a high prevalence with about 9 million cases occurring annually. ZN microscopy is the most widely used technique to detect AFB, but it is less sensitive. However fluorescent microscopy is more helpful with simple diagnostic criteria. Gene Xpert® MTB/RIF assay is a rapid molecular assay that enables diagnosis of TB with simultaneous detection of rifampicin resistance. The diagnostic accuracy of fluorescent microscopy and Gene Xpert MTB/RIF for the diagnosis of TB were evaluated.

A total of 352 respiratory specimens were tested among which 160 samples were positive by culture. Out of culture positive samples, 158 samples (98.7%) were GeneXpert TB positive while 2 were negative. While only 49 were positive on ZN microscopy and 89 were positive on fluorescent microscopy. Out of the culture negative samples, 2 were positive with ZN microscopy, one was positive with fluorescent microscopy and 3 were positive on Gene Xpert. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of ZN Smear microscopy was 39%, 99.5%, 96%, 63% and 14.5% respectively. Sensitivity, specificity,PPV, NPV and diagnostic accuracy of fluorescent smear microscopy was 55% and 99.5%, 98%, 72% and 79% respectively. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of Gene XPERT was 98 % and 99%, 98%, 99% and 98% respectively.

In countries like Pakistan where the disease is endemic, fluorescent microscopy and Gene Xpert PCR can help in making a timely diagnosis.

Key words: Pulmonary Tuberculosis, Fluorescent microscopy, Gene Xpert, Auramine phenol stain

Frequency of Endometriosis among Infertile Women on Diagnostic Laparoscopy

Nousheena Akhter Shabir*, Rubina Rafique** and Sehr ul Ain Raja*

*Department of Gynaecology & Obstetrics Combined Military Hospital (CMH)Muzaffarad, Azad Kashmir, **Department of Medicine AIMS, Muzaffarad, Azad Kashmir



Introduction: A condition in which there is failure of conceiving child after frequent sexual intercourse that is unprotected for 12 months or more is known as infertility. A variety in clinical presentation, difficult diagnosis and management makes endometriosis a challenging medical problem. Clinical information related to ovarian and tubal status, normality of uterine and some proper procedure for diagnosis of many pelvic pathological conditions such as pelvic inflammation, pelvic congestion, endometriosis and tuberculosis can be obtained by laparoscopy.

Objective: To determine the frequency of endometriosis on diagnostics laparoscopy in females with infertility.

Material & Methods: This cross-sectional study was done at the department of Obstetrics & Gynecology Combined Military Hospital (CMH) Muzaffarabad, Azad Kashmir to determine the frequency of endometriosis on diagnostics laparoscopy in infertile women. The duration of the study was 6 months (from October 30, 2016 to April 30, 2017). The participants were taken had age 18-45 years with primary complain of primary or secondary infertility were subjected to diagnostic laparoscopy and were diagnosed to have endometriosis as the cause of infertility were included in the study.  Sample size for the study was taken by non-probability, consecutive sampling of 170 females. Data from 82 female undergoing diagnostic Laparoscopy meeting inclusion criteria was taken from department of Obstetrics & Gynecology. After taking informed written consent basic demographical details like age, name and contact details were taken. A clinical examination was carried out during patient’s inclusion. The quantitative data like age and duration of infertility were reported in Mean ± S.D while the categorical data like type of infertility and endometriosis were reported in Frequency (%).  To address effect modifiers data was stratified for female’s age, duration of infertility and types of infertility (primary or secondary). Post stratification Chi-square test was used considering, p-value ≤ 0.05 as significant.

Results: The mean age of cases in this study was 31.56±8.19 years with mean duration of infertility was 10.16±5.05 months. There were 36(21.18%) who had < 6 months and 134(78.82%) cases had ≥ 6 months of duration of disease. There were 76(44.71%) cases that had primary and 94(55.29%) cases had secondary infertility. According to operational definition a total of 23(13.53%) cases had endometriosis.

Conclusion: The frequency of endometriosis in females with infertility is considerably higher. In future these females can be prevented from endometriosis by early screening and with appropriate medication.

Keywords: Pregnancy, Infertility, Laparoscopy, Endometriosis

Clinical and Histopathological Spectrum of Ameloblastoma

Uzma Bukhari*, Durr-e-Sameen Kamran* and Hira Salam**

*Department of Histopathology,

**Department of Oral Pathology

Dow University of Health Sciences, OJHA campus, Karachi



Introduction: Ameloblastoma is a rare neoplasm of odontogenic origin with estimated global incidence at 0.5 per million-person years. Tumor, although benign has the tendency to invade adjacent tissues. Regional variations in occurrence of various odontogenic tumors have been reported. With this experiential data, we aimed to identify the prevalent pattern for presentation of ameloblastoma in our population over 6 years of study period.

Patients and Methods: All biopsy specimens diagnosed as ameloblastoma at histopathology section of Dow Diagnostic Research and Reference Lab (DDRL), Dow University of Health Sciences (DUHS),during the study period (January 2010 – December 2015) were included in the study. The slides were reviewed along with the clinical information was recorded on specifically designed proforma.

Results: 42 cases of ameloblastoma diagnosed by histopathology department at DDRL (DUHS) during the entire study period. A wide age range (3 years to 80 years) was observed with mean age 32 years at presentation. Highest incidence was recorded in 20-40 years age group. A slight male preponderance was noted (57%). Majority of the cases were intraosseous (76%) amongst which mandible (87.5%) was the most frequent site.

Conclusion: Ameloblastoma is a rare neoplasm, a fact highlighted by our recording only 42 biopsied cases over a span of 6 years. Even though the tumor has a predilection for higher age group and males, we recorded cases in both extremes of age. Therefore, ameloblastoma should be considered in differential diagnosis of odontogenic tumors at both extremes of age.

Keywords: Ameloblastoma, Mandible Tumors, Dental Tumors, Oral Pathology