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Bangalore, India

Siddappa S.,Victoria Hospital Campus | Mythri K.,Institute of Nephro Urology | Kowsalya R.,Institute of Nephro Urology
Journal of Cytology | Year: 2012

Background: Regardless of the availability of newer and more sophisticated modalities of investigation, urinary tract cytology still remains the most commonly used non-invasive test for the diagnosis of bladder cancer. Aims: As hematuria is the commonest presenting symptom in patients with malignancy of urinary tract, we undertook this study to know the usefulness of urine cytology in evaluation of the hematuric patients for malignancy. Materials and Methods: A total of 21,557 fresh voided urine samples received at our tertiary care referral centre over a period of three years were included in the study. Of these, 1428 cases had hematuria, criteria of either gross or microscopic. Results: Among these hematuric cases included in the study, 32.5% (464 cases) were found to have positive finding of atypical cells. In these cases with atypia, 9.5% (136 cases) were proved to have malignancy both with the histopathological biopsy and cystoscopic findings. Other cases of atypia were found to be of reactive origin, either due to instrumentation or foreign body. A large number of hematuric cases, that is, 964 cases (67.5%) were negative for atypical cells. Conclusions: The limited ability of urine cytology to detect low grade bladder tumors, its subjectivity and lack of uniformity in reporting, all render urine cytology a less than perfect tool. With added collaboration between clinician and cytopathologist, urine cytology can be used an adjunct tool in evaluation of patients with hematuria.

Shoorashetty R.M.,Pondicherry Institute of Medical science | Nagarathnamma T.,Victoria Hospital Campus | Prathibha J.,Victoria Hospital Campus
Indian Journal of Medical Microbiology | Year: 2011

Purpose: Extended spectrum β-lactamase (ESBL) and AmpC β-lactamase are important mechanisms of betalactam resistance among Enterobacteriaceae. The ESBL confirmation test described by Clinical Laboratory Standards Institute (CLSI) is in routine use. This method fails to detect ESBL in the presence of AmpC. Therefore, we compared two different ESBL detection methods against the CLSI confirmatory test. Materials and Methods: A total 200 consecutive clinical isolates of Enterobacteriaceae from various clinical samples were tested for ESBL production using (i) CLSI described phenotypic confirmatory test (PCT), (ii) boronic acid disk potentiation test and (iii) cefepime-CA disk potentiation method. AmpC confirmation was done by a modified three-dimensional test. Results: Among total 200 Enterobacteriaceae isolates, 82 were only ESBL producers, 12 were only AmpC producers, 55 were combined ESBL and AmpC producers, 14 were inducible AmpC producers and 37 isolates did not harboured any enzymes. The CLSI described PCT detected ESBL-producing organisms correctly but failed to detect 36.3% of ESBLs among combined enzyme producers. The boronic acid disk potentiation test reliably detected all ESBL, AmpC, and combined enzyme producers correctly. The cefepime-CA method detected all ESBLs correctly but another method of AmpC detection has to be adopted. Conclusion: The use of boronic acid in disk diffusion testing along with the CLSI described PCT enhances ESBL detection in the presence of AmpC betalactamases.

Siddappa S.,Victoria Hospital Campus | Ramprasad K.,Victoria Hospital Campus | Muddegowda M.K.,Victoria Hospital Campus
Korean Journal of Urology | Year: 2011

Purpose: Xanthogranulomatous pyelonephritis is an uncommon disorder of unknown etiology that is characterized by extensive destruction of the involved kidney. It is being increasingly recognized as an important cause of renal morbidity around the world. Materials and Methods: This retrospective study was undertaken to review the xanthogranulomatous pyelonephritis cases presented at our tertiary care referral center in Bangalore, India. Results: A total of 16 biopsy-proven cases of xanthogranulomatous pyelonephritis from October 2007 to March 2010 treated at our institute were included in the study. There were 10 females and 6 males with a mean age of 51.5 years. Flank pain was the most common presenting symptom followed by fever. All patients had unilateral disease and underwent total nephrectomy of the affected nonfunctional kidney. Conclusions: Xanthogranulomatous pyelonephritis is a chronic and unusual infectious inflammatory condition involving the renal parenchyma. The definite treatment is nephrectomy. Early identification and prompt treatment of this relatively benign and uncommon condition is important to minimize morbidity and mortality. © The Korean Urological Association, 2011.

Shanthala G.B.,Victoria Hospital Campus | Rudresh S.M.,Victoria Hospital Campus | Nagarathnamma T.,Victoria Hospital Campus
Journal of Clinical and Diagnostic Research | Year: 2011

Chromoblastomycosis is a chronic fungal infection which is caused by the phaeoid fungi which are commonly seen in the tropical and subtropical climates. This infection is thought to be secondary to trauma or autoinoculation. The aetiological agent is a small group of dermatiaceous (pigmented) fungi. At least five species of fungi have been recognized to cause chromoblastomycosis: Cladosporium carrionii, Fonsecaea compacta, Fonsecaea pedrosoi, Phialophora verrucosa, and Rhinocladiella aquaspersa. Here, we report a case of chromoblastomycosis from Karnataka, India. A 72 years old male patient presented with a history of a vegetating ulcer with crusting. The diagnosis of chromoblastomycosis was made by a demonstration of sclerotic bodies on KOH and the isolation of Cladophialophora carionii on culture. The unique feature in this case is that it responded to the medical line of treatment with fluconazole.

Shantala G.B.,Victoria Hospital Campus | Shetty A.S.,Victoria Hospital Campus | Rahul Rao K.,Victoria Hospital Campus | Vasudeva,Victoria Hospital Campus | Nagarathnamma T.,Victoria Hospital Campus
Journal of Clinical and Diagnostic Research | Year: 2011

Therapeutic failure to Clindamycin has been reported due to mechanisms which confer resistance constitutively, or by the presence of low level inducers which can lead to therapeutic failure. Therefore, this study was undertaken to identify the strains that have the potential to become resistant during therapy. Inducible Clindamycin resistance was tested by the Clindamycin disc induction test (D test) as per the CLSI recommendations. The study showed 54.78% MRSA isolates and 32.5% inducible Clindamycin resistant isolates among them as compared to 15.53% in MSSA isolates. We concluded that routine screening for inducible resistance to Clindamycin must be performed so that the drug is used effectively and for maximum clinical utility.

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