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Priyanka Sharma, Rahul Verma,
Volume 17, Issue 2 (Mar-Apr 2023)
Abstract

Background and objectives: Granulomatous disorders of the skin are frequently encountered in clinical practice and require histopathological confirmation due to a considerable etiological and clinical overlap. A single histopathological pattern may be produced by many causative agents and at the same time, a single cause can present with varied histopathological patterns. The present study was performed to evaluate the histomorphological patterns of granulomas in various granulomatous skin lesions and to identify the causative agents.
Methods: The study (both prospective and retrospective) was carried out in the department of pathology over 5 years. All skin biopsies were evaluated for the presence of granulomas. Detailed analysis of the histopathological pattern of granulomas was performed and categorization was made according to the type and etiology. Special stains were also used when required. A clinicopathological correlation was established with the Kappa statistic.
Results: Of 1,150 skin biopsies, granulomatous skin lesions were observed in 325 cases. Histiocytic granuloma pattern was the most common subtype (55.7%). The predominant etiology of granulomatous inflammation was leprosy (93.5%), followed by cutaneous tuberculosis (2.7%). The cases of Hansen’s disease showed a maximum clinicopathological correlation (58.5%).
Conclusion: Histopathological examination is the gold standard for the diagnosis and subtyping of granulomatous skin lesions. Varied morphologies of granuloma patterns were observed in our study, and infectious diseases were the causative agents in the majority of cutaneous granulomatous disorders. 
Thivyah Prabha, Rasheed Khan, Shruthi Cn, Rathi Priya,
Volume 17, Issue 6 (Nov-Dec 2023)
Abstract

Background: Thyroid disorders are the most common cause of endocrine dysfunction among women of childbearing age. It is well-established that hypothyroid dysfunction can have significant adverse effects on pregnancy and fetal development. This study aimed to determine the prevalence of thyroid disorders among antenatal women and assess the maternal and fetal outcomes in pregnant women with hypothyroid disorders.
Methods: This prospective study was conducted in the antenatal clinic of the Department of Obstetrics and Gynaecology in association with the Biochemistry Department. After obtaining written informed consent, antenatal women aged 18-40 years were included in this study, regardless of their gestational period. Venous blood samples were collected from the antecubital vein, and thyrotropin, free triiodothyronine (free T3), and free thyroxine (free T4) levels were measured. Hypothyroid antenatal women were monitored throughout their pregnancies to evaluate maternal and fetal outcomes.
Results: Among the participants in this study, 149 antenatal women had thyroid disorders, with a prevalence rate of 12.6%. Subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, and overt hyperthyroidism were observed in 6.9%, 3.2%, 1.8%, and 0.7% of cases, respectively. Maternal complications included oligohydramnios (5.8%), preeclampsia (13.3%), and preterm delivery (5%), while fetal complications included low birth weight (20.8%), hyperbilirubinemia (9.1%), and neonatal intensive care unit (NICU) admissions (13.3%).
Conclusion: A high prevalence (12.6%) of thyroid disorders, particularly hypothyroidism (10.1%), among pregnant women, emphasizing the importance of routine thyroid testing for all antenatal individuals.



Hina Rahangdale, Tejaswini Olambe, Priyanka Klabhor, Sangita Bhalavi, Varsha Wanjare, Sunanda Shrikhande,
Volume 18, Issue 2 (Mar-Apr 2024)
Abstract

Background: Urinary tract infections (UTIs) are among the most common types of infections affecting people in community and hospital settings. Bacteria are the leading cause of UTIs, followed by fungi. 39% of all healthcare-associated infections (HAIs) affecting all age groups are UTIs, causing high morbidity and mortality rates. The antibiotic susceptibility pattern of causative organisms is changing due to improper antibiotic use. The study was conducted to determine the microbiological profile of both community and HAIs and their antimicrobial susceptibility pattern.
Methods: Clean-catch, mid-stream urine samples collected in the universal wide-mouthed sterile containers were transported to the laboratory. Samples were processed by standard conventional microbiological procedures. Antimicrobial susceptibility was done using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar plates.
Results: The most common causative organisms among gram-negative bacteria were E coli (26.05%), followed by Klebsiella spp (20.37%), and Enterococcus spp (12.81%) was more common among the gram-positive bacteria. Non-albicans Candida (64.10%) were more commonly isolated than Candida albicans (35.90%). E coli was highly susceptible to nitrofurantoin and fosfomycin, and Klebsiella spp and Enterococcus spp were similarly highly susceptible.  Antibiotic resistance was more common among bacteria isolated in HAIs.
Conclusion: In both settings, E coli was the most common causative organism. The incidence of non-albicans Candida species has increased in comparison to Candida albicans. Antimicrobial susceptibility to empirical 3rd-generation cephalosporins and fluoroquinolones has drastically decreased. Hospital-acquired UTIs are a rising threat to the healthcare system and community. Based on hospitals’ antimicrobial policy formulated by studying antimicrobial susceptibility patterns, empirical treatment should be chosen.

 
Bhawana Bajare, Akanksha Dhangar, Supriya Tankhiwale, Sunanda Shrikhande,
Volume 18, Issue 2 (Mar-Apr 2024)
Abstract

Background: Pyogenic infection is a significant cause of morbidity. Infection with multidrug-resistant strains poses a major difficulty in the treatment. The study was conducted to know the bacteriological profile of pyogenic infections and their antibiotic susceptibility.
Methods: A cross-sectional study was conducted in a tertiary care hospital from October 2021 to March 2022. Isolates from pus specimens were subjected to an antibiotic sensitivity test using the Kirby-Bauer method as per CLSI 2021.
Results: Out of 752 samples, etiology could be revealed in 510 (68.4%) specimens. Enterobacterales dominated the profile, with K pneumoniae isolated in the maximum number of specimens. Staphylococcus aureus was the culprit in 14% of the cases. Non-fermenters were isolated in 17% of the cases. Methicillin resistance in S aureus was 67%. Gram-positive cocci showed high sensitivity to linezolid. For both Piptaz and carbapenem, Enterobacterales and non-fermenters showed around 50% and 60% susceptibility, respectively.
Conclusion: Continuous surveillance of the aetiologic agents of pyogenic infections and their antibiotic sensitivity pattern needs to be done to design and implement the antibiotic policy for the infection in our set-up.

Supriya Gulajkar, Rajni Shivkar, Sanjyoti Panchbudhe, Charushila Kadam,
Volume 19, Issue 1 (4-2025)
Abstract

Background and Objectives: Quality control (QC) is a crucial tool in the clinical laboratory for error identification and correction. While IQC ensures daily precision and accuracy, EQAS ensures long-term accuracy by providing external verification. The objective of this study was to evaluate our laboratory’s performance in the EQAS program and assess the impact of corrective actions on EQAS performance improvement.
Methods: The retrospective observational study was undertaken in the tertiary care hospital. The Biochemistry department of the laboratory participated in the monthly clinical chemistry EQA program administered by CMC Vellore EQAS. Nineteen parameters were assessed using structured approach to analyze deviating EQAS results. Monthly performance was analyzed in terms of the SDI (Standard Deviation Index) and VIS (variance index score) for the period of October 2019 to September 2021.
Results: Among the nineteen parameters assessed in EQAS program, most showed ‘excellent’ performance between October 2019 and September 2021 based on mean SDI. Some improvement was observed in the SDI values between the two cycles after implementing a structured approach in root cause analysis and indicates an enhanced level of performance in the EQAS program. The VIS analysis revealed that 89.47% of parameters in the October 2019 to September 2020 period and 94.73% in the October 2020 to September 2021 achieved scores classified as ‘very good’ performance.
Conclusion: Adopting a structured approach to analyze deviating EQAS results enables the evaluation of laboratory performance and offers opportunities for improvement. Consequently, EQAS plays a significant role as a cornerstone in the accreditation process.

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