Background: Bone marrow aspiration and trephine biopsy are two most important techniques which are complementary for diagnosing both neoplastic and non- neoplastic haematological diseases. The present study was conducted in the department of pathology to compare the role of bone marrow aspirate and trephine biopsy for diagnosing the haematological diseases.Methods: The study was conducted in the department of pathology government medical college Srinagar over a period of 2 years from Feb 2016 to Jan 2018. The study was one-year retrospective and one year prospective. Bone marrow aspiration was done in 626 cases out of which biosy was done in 300 cases.Results: Out of the selected 300 cases were both aspiration and trephine biopsy were available, diagnostic material on bone marrow aspirate was adequate in 288 cases. 12 cases were aparticulate. Biopsy was inadequate in 8 cases. Overall megaloblastic anaemia (26.6%) was most common followed by dual deficiency anemia. Multiple myeloma was the most common neoplastic pathology (13%) followed by followed by acute leukaemia’s (6%) and Chronic lymphoproliferative disorders (CLPDS) (5%). 1 case each of visceral leishmaniasis and malarial parasite were also noted. 4 cases (1.3%) of granulomatous pathology and 2 cases (0.6%) of Hodgkins lymphoma were diagnosed exclusively on bone marrow biopsy.Conclusions: Bone marrow aspiration and biopsy are complimentary to each other in diagnosing hematological disorders with biopsy being gold standard in the assessment of cellularity, pattern, extent of tumor infiltration and focal infiltration. It is more helpful in diagnosing granulomatous pathology and metastatic deposits of tumors eliciting fibrotic response.

Providencia rettgeri is a member of Enterobacteriacea that is known to cause urinary tract infection (UTI), septicemia, and wound infections, especially in immunocompromised patients and in those with indwelling urinary catheters. It is an uncommon cause of UTI and sepsis but should be suspected in patients with predisposing factors. The condition has high mortalty and warrants early recognition and treatment. We present here a case of UTI with sepsis by Providencia rettgeri in a young female during post partum period. She had recently delivered a male baby and was catheterized for 10 days. Patient received intravenous antibiotis and recovered completely. …………………………………………………………………………………………………….... Introduction:-The genus Providencia is a member of theEnterobacteriaceae family which commonly dwells in soil, water, and sewage [1]. Human isolates of Providencia species have been recovered from urine, throat, perineum, axilla, stool, blood and wound specimens. The organism is usually isolated from genitourinary and gastrointestinal sources (urine, faeces and perineum), causing diarrhoea and urogenital symptoms .Providencia rettgeri (P. rettgeri) is a motile, gram-negative rod shaped organism and a member of the Enterobacteriaceaefamily [1]. It is inherently resistant to many antibiotics and thus early identification and treatment is needed to treat this infection. We present a case of urinary tract infection during post partum period in a female who had recently delivered and was catheterized.Case report:-A 24 year old young female presented to the OPD with history of dysuria and fever . The fever was high grade and intermittent type. The female had delivered a male baby ten days earlier by cesarian section she had been catheterised for 10 days . General physical examination was normal except for elevated temperature . Heamogram revealed TLC of 12000 . Chest X ray was normal. Urine was sent for culture and sensitivity in our lab. The urine was inoculated on HiCrome agar using a calibrated loop. Inoculated plates were incubated at 35 degree C for 24 hours. Next day plates were examined for colony morphology.Gram smear showed short rod shaped cells ,0.5-0.8 µm. colonies were glossy, white 2-3mm. Providencia rettgeri Was isolated from urine and blood (figure 1).culture revealed that the isolate was resistant to ampicillin, ampicillin/sulbactam, cefazolin, gentamicin, and trimethoprim/ sulfamethoxazole. It was found to be susceptible to ceftriaxone, cefepime, ciprofloxacin, and piperacillin/tazobactam The patient was admitted put on iv ceftrioxone and had complete recovery.

Background: Central nervous system (CNS) tumors constitute about 1-2% of all the tumors. They are the 6th most common tumors in adults and 2nd most common among childhood tumors. Gliomas are the most common CNS neoplasms. In addition to gliomas temporal lobe has predilection for some peculiar tumor subtypes having good prognosis, including pleomorphic xanthoastrocytoma (PXA), low grade astrocytic tumors and dysembryoplastic neuroepithelial tumor (DNET) in children.Methods: Study was conducted in the department of pathology Sher-e-Kashmir institute of medical sciences (SKIMS) Soura, Srinagar Kashmir India. This was six-year study.Results: Temporal lobe tumors were commonly seen in 3rd to 4th decade of life accounting for 37.9% of the cases followed by 4th to 5th decade (27.5%). The mean age of presentation being 40±10 yrs. Males outnumbered females with a male: female ratio of 1.7:1. Intraoperative squash smears were mostly reported as High grade gliomas (WHO Grade III-IV) accounting to a total of 42 cases (36.2%). On histopathology frequent temporal lobe tumor seen was Glioblastoma multiforme (GBM) 17.4%, followed by pleomorphic xanthoastrocytoma and oligodendroglioma accounting for 14.6% of cases each. On comparing the diagnostic accuracy of intraoperative squash smears to that of Histopathological diagnosis an overall accuracy of 86.2% was observed.Conclusions: Intra operative squash technique in CNS tumors is universally accepted method. In temporal lobe lesions, on adequate sampling and careful examination, squash cytology has fairly good diagnostic accuracy rate of 86.2% when compared to histopathology.

Introduction: Multidrug resistant bacteria is causing a very serious problem in the proper treatment and management of sick patients in ICU's. Study aimed to find out antimicrobial susceptibility pattern of bacterial isolates from tracheal culture. Material and methods: This study was carried over a period of 6 months from July to December 2017 in the department of microbiology. Total of 470 tracheal aspirates were studied. Each specimen was streaked on 5% sheep blood agar and MacConkey agar. After isolation and identification, sensitivity of selected organisms against different antibiotics was studied Results: Out of 470 tracheal aspirates, 328 samples showed single bacterial growth, 76 were sterile; contaminants were grown in 58 samples and in remaining 8 samples yeast were grown. The incidence of positivity in our study was 83.8%, with gram negative bacteria outnumbering the gram positive ones. Of the 328 samples which showed bacterial growth, Acinetobacter spp 159(40.3) was the most common organism followed by Klebsiella pneumoniae 72(18.2), Pseudomonas spp 46(11.6), Escherichia coli 27(6.8), Staphylococcus aureus 13(3.2), Klebsiella oxytoca 5(1.26), Enterococcus spp 3(0.76), Proteus spp, Citrobacter spp, Providencia stuartii 1(0.25) each. Also XDR (extensively drug resistant) bacteria were isolated at a high frequency (67%) with Acinetobacter spp. being the most common 128(56.6)) followed by Klebsiella spp. 39(17.2) Pseudomonas spp. 38(16.8), and E.coli 12(5.3). Conclusion: Gram negative were main organisms responsible for lower respiratory tract infections in hospitalized patients and the majority of the isolates belong to XDR and MDR category.

Background: Carbapenems are considered the broadest-spectrum β-lactam agents and are often required for treatment of severe hospital-acquired infections caused by multidrug-resistant Gram-negative organisms. Minimum inhibitory concentrations (MICs) are important in diagnostic laboratories to confirm resistance of microorganisms to an antimicrobial agent and also to monitor the activity of new antimicrobial agents. Aims and Objectives: To compare the MIC obtained by Broth Microdilution method (BMD) with that of Vitek-2(automated method) for recovered isolates of Klebsiella pneumoniae. Materials and Methods: Prospective study conducted over a period of one year. It included all isolates of Klebsiella pneumoniae recovered from blood culture of the patients. The identification and antimicrobial susceptibility was done on Vitek-2.These Isolates were subjected to Microbroth dilution method for MIC determination. Results: Out of the 55 meropenem resistant  isolates by vitek-2, 20(36.3%) had MIC of ≥256 µg/ml followed by 18(32.7%) isolates with a MIC of 128 µg/ml, followed by 11(20%) isolates with MIC of 64 µg/ml and 6(10.9%) isolates with MIC of 32 µg/ml. Also among 15 meropenem sensitive isolates by Vitek-2, 13(86.7%) had MIC of ≤0.5 µg/ml, followed by two (13.3%) isolates with MIC of 2 µg/ml. Results obtained by vitek 2 were compared with those from BMD(the reference method), which showed a 13.3% minor error rate and no major or very major error rate. Conclusion: Overall, the Vitek 2 performance was comparable to that of BMD for testing a limited number of Klebsiella pneumoniae isolates.