Archive for February, 2014

“Assessment of palpable breast masses in north Indian women using triple test” ShekharUpadhyay, Rajesh Chakravarty, NaliniCalton, William Bhatti

Abstract  Introduction:Triple test (mammography, Fine needle aspiration cytology and physical examination) can be used accurately in patients presenting with palpable breast masses. We studied the sensitivity, specificity and predictive values of the three components.Aims and Objectives:This study aimed at the assessment of palpable breast masses in north Indian women using triple test.Materials and Methods: Prospectively for one year 52 female patients who presented with a palpable breast lump were assessed using all three components of the triple test.Results:Physical examination showed 57.14% sensitivity, 100% specificity and 100% positive predictive value. Fine needle aspiration cytology (FNAC) showed 71.43% sensitivity, 96.97% specificity and 90.91% positive predictive value whereas mammography revealed 50% sensitivity, 100% specificity and 100% positive predictive value. The overall predictive value of the triple test score was 94.87%Conclusions:Triple Test i.e. combined physical, radiologic and cytological diagnosis is more sensitive and specific than any procedure used alone. The study shows that when TT is concordant i.e. TTS score is more than 6, the final treatment may be ensued without confirmatory biopsy.

Abstract Purpose: This study was done to analyze the frequency, extent and methods of microbiological surveillance of OT, efficiency, microbicidal activity  of  product X, advantages of special air filters, air quality , rate and   factors contributing to SSI . Materials & methods:   Surveillance was done in two conventional OTs (GH) and two with special air filters(private) by settle plate, air sampler and surface swab for aerobe & anaerobe, from day 1- 6 in the morning & evening , after formalin and product X.  Microbicidal activity of product X was tested against common isolates. Results:       By settle plate or air sampler, the cfu were less with product X compared to formalin, the M- cfu were less than E- cfu and the cfu in the private OTs were less compared to GH. There was no gradual decrease or increase of cfu from day 1 to 6.Organisms isolated  were Acinetobacter baumanii, CoNS, MSSA and  micrococci in GH,  aerobic spore forming bacilli and  micrococci in private. RCM was negative for Clostridium tetani in all four OTs.  SSI was 14% in GH and Nil in private. Microbicidal activity of product X was good at 1% concentration within 10 mts. Conclusion: Air sampler measures the microbial burden more  accurately..  Settle plate is a direct indicator of SSI risk.  Clostridium tetani as an indicator of air quality may be limited to special situations only.. Peptone water swabs indicate the seriousness of the contaminant. Newer less toxic disinfectants are alternative to formalin. Correlation between microbial burden and SSI by any method is not absolute.