Objective: To determine the diagnostic accuracy of serologic (IgG) in the diagnosis of Helicobacter Pylori among patients of dyspepsia by taking Helicobacter pylori Stool Antigen (HpSA) as the gold standard. Material and methods: The study was conducted in Microbiology Department, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi with the collaboration of gastroenterology OPD. All the patients with a history of dyspepsia, above 25 years of age and of either gender were included. After taking informed consent the clinical samples of blood and stool from patients were taken. A 6 ml venous blood was taken from the antecubital vein for detecting IgG antibody to H. pylori. Stool samples were collected for detecting H. pylori antigen in a wide mouth, sterile, leak proof container properly labeled by serial number and stool samples were stored in a refrigerator at 4°C up to 72h. On the specimens containing H. pylori antibodies, a colored line appeared in the test line region consider a positive result. H. pylori antigen was detected in stool (HpSA) by rapid chromatographic immunoassay. During analysis, the specimen responds with an anti-H. pylori antibody-coated particle. By capillary action, the mixture migrates upward on the membrane, reacting with anti-H. pylori antibodies on the membrane to produce a colorful line. A positive result is indicated by the presence of this colored line in the test zone, whereas a negative result is indicated by its absence. All the data were obtained using a study proforma, and the data was analyzed using SPSS version 26. Results: A total of 210 patients presented with dyspepsia were studied, their mean age was 49.07±10.97 and females were in majority (71.9%). H. Pylori was positive among 137 cases, those who underwent serological test (IgG) and 127 were positive for stool antigen (HpSA). The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Conclusion: The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Key words: H. pylori, diagnosis, IgG, Stool antigen
Objective: The efficacy of fosfomycin against ESBL and/or carbapenem-resistant E. coli isolated from urine samples was determined. Methodology: Three hundred fifty (350) urine samples were collected from the patients having UTI visited to the department of Urology, JPMC, Karachi. The CLED agar was used for the primary isolation of uropathogens. Regular antimicrobial sensitivity testing was conducted in accordance with CLSI standards, and the minimum inhibitory concentration (MIC) of fosfomycin was assessed using E-strips. Results: Out of 350 urine samples 213 (60.85%) were E. coli. Patients with E. coli had an average age of 38.75 15.01 years. Females are more prone to have UTI 146(68.54%). E. coli was highest among uropathogens having frequency of 213(60.85%). E. coli manifest highest resistance to ampicillin 187(87.79%) and low resistance to meropenem 12(5.63%), imipenem 15(7.51%) and fosfomycin 21(9.85%). The overall carbapenem resistant E. coli was 9(6.4%) and majority of (61.5%) fosfomycin resistant E. coli, MIC value was >1024µg/ml. Isolates were categories in the non-MDR, MDR and XDR. Most of the isolates were MDR (53%), followed by the non-MDR (35%) and XDR (11%). Conclusion: In conclusion present study suggests that fosfomycin is still effective against E. coli. More than 50% E. coli isolates were MDR and it’s an alarming situation for urologist.
Objective: To detect treatment outcomes in current smokers, ex - smokers and nonsmokers, in newly diagnosed pulmonary TB patients. Methodology: This cohort prospective study was conducted in the department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi, with the collaboration of different (DOTS) centers of Pathology Karachi Medical and Dental College, Karachi. All newly diagnosed pulmonary TB patients registered for treatment either of gender were included. The patients were divided into three groups. Group-A: Current smokers, Group-B: Ex-smokers, Group-C: Non-smokers. Patients were followed for 6 months. Outcome was assessed in terms of cured or failure. All the information was enrolled in pre-designed proforma. Data was analyzed by using SPSS version 20. Results: In current study mean age of non-smokers was 44.20±17.73, ex-smokers 43.13±15.67 years mean age of smokers was 38.07±15.67 years. Males were in majority in all study groups as in ex-smokers group, males were 98.75%, non-smoker males were 90.0% and in smoker group males were 92.50%. At starting of treatment, mean weight of smoker patients was 55.50±5.41 kg, ex-smoker’s 48.91±9.00 kg and mean weight of non-smokers 48.71±7.04 kg. P-0.001. At starting of treatment, the mean ESR of non-smokers was 89.31±10.02, ex-smoker’s was 82.62±12.18 and smokers ESR average was 80.61±15.83. P-0.001. After 6 month treatment, cured rate was (96.25%) in non-smokers, (90%) in smokers and (93.75%) in ex–smokers. Conclusion: This study concluded that cured rate was high in non-smokers. Smoking status in individuals greatly affects the tuberculosis treatment outcome with enhance failure rate.
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