Nasal polyp : A clinico histological study

A total of 113 cases of nasal polypi from almost all age groups, having almost equal sex incidence, were subjected to clinico histological study, in an attempt to subgroup nasal polyp on etiological basis. History of allergic manifestations could not be elicited in most of the cases (65.5%). Ulceration with ciliated columnar and transitional epithelium were seen in good number of cases (93.8%). Infiltration of stroma by lymphocytes, plasma cells, macrophages, eosiniphils and mast cells Were plenty to moderate in number with almost equal frequency, although 22.1% of cases showed poor number of eosinophils and mast cells, while polymorphs in poor number were detected in 70.8% of cases. Stroma was severely or moderately oedematous in most of the cases. Presence of amyloid like material was noted in 80.6% of cases. Atypical mesenchymal cells were seen in plenty to moderate number in 36 3% of cases. Seventy six cases could be followed up, of whom 11 cases showed recurrence within 6 months. Histological picture in these cases didnot reveal mesenchymal cell atypicality as a factor for recurrence. The present study also could not catagorise the nasal polypi as allergic or nonallergic on the basis of gland histology and character of cellular infiltrate.     

Rapid detection of methicillin resistance in staphylococci using a slide latex agglutination kit

The slide latex agglutination test, MRSA-Screen, was compared with the mecA polymerase chain reaction (PCR) and traditional susceptibility test methods for the detection of methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci. The MRSA-Screen test detected the same number of methicillin-resistant S. aureus as the mecA PCR and the traditional susceptibility tests. It correctly identified all 21 methicillin-susceptible S. aureus as being sensitive. It also produced the same result as the mecA PCR in identifying a methicillin-resistant S. aureus among six isolates classified as borderline resistant by traditional susceptibility tests. The MRSA-Screen test and mecA PCR detected methicillin resistance in 10 and 15 of 17 methicillin-resistant coagulase-negative staphylococci, respectively. From these results, it is concluded that the MRSA-Screen is a very accurate, reliable and rapid method of detecting methicillin resistance in S. aureus and is suitable for use in clinical microbiology laboratories. Further study of its use in detecting methicillin resistance in coagulase-negative staphylococci is required.     

Bengali adaptation of brief patient health questionnaire for screening depression at primary care

Depression is a common mental disorder quite prevalent at the primary care level and needs proper identification and prompt treatment. Bengali adaptation and validation of such an instrument (BPHQ) is aimed to provide a sensitive screening instrument that can help primary care physicians in the identification of depression correctly and easily.     

The use of intraoperative cystoscopy in major vaginal and urogynecologic surgeries

OBJECTIVE: Our purpose was to examine the frequency of significant intraoperative cystoscopic findings during major vaginal reconstructive and urogynecologic surgeries. STUDY DESIGN: The records of 526 consecutive women who underwent routine cystoscopy with intravenous injection of indigo carmine at the time of their urogynecologic and major vaginal reconstructive procedures between January 1, 1997, and April 20, 2001, were reviewed. We determined the incidence of significant cystoscopic findings and their effect on intraoperative management. Two-tailed t tests and logistic regression analyses were used to compare characteristics between the groups with and without significant cystoscopic findings. RESULTS: During the 526 operations, 26 significant findings (4.9%) were unsuspected before cystoscopy and 15 (2.9%) of these findings were operative injuries that required intervention. Seventy-nine subjects (15.0%) had no anti-incontinence operation performed. Of these patients, there was one partial ureteral obstruction from an anterior colporrhaphy (1.3%). Seven of 184 Burch procedures (3.8%) resulted in injuries to the lower urinary tract, of which 3 (1.6%) required intervention that were unrecognized before cystoscopy. Seven of the 15 cases resulting in changes in intraoperative management were caused by anterior colporrhaphy sutures (2.0% of all anterior colporrhaphies). There were no unrecognized injuries that caused morbidity after surgery. There were no significant differences between patients with abnormal and normal cystoscopic findings in regard to mean age, weight, parity, estimated blood loss, previous surgery, or previous incontinence surgeries. No complications or morbidity occurred as a direct result of intraoperative cystoscopy. CONCLUSION: Intraoperative cystoscopy with intravenous indigo carmine is a safe and effective way to detect injury of the lower urinary tract. Cystoscopy detected unsuspected operative injuries in 2.9%. In cases that did not involve anti-incontinence procedures, the rate of injury was 1.3%. With a significant rate of detection, cystoscopy allows for immediate recognition and easier repair of lower urinary tract injury, lowering the patient's risk for morbidity. Anterior colporrhaphy was the most common cause of unrecognized ureteral compromise.