BackgroundRapid and reliable diagnostic assays for enteric (typhoid and paratyphoid) fever are urgently needed. We report the characterization of novel approach utilizing lymphocyte secretions, for diagnosing patients with enteric fever by the TPTest procedure.MethodologyTPTest detects Salmonella-specific IgA responses in lymphocyte culture supernatant. We utilized TPTest in patients with suspected enteric fever, patients with other illnesses, and healthy controls. We also evaluated simplified modifications of TPTest for adaptation in laboratories with limited facilities and equipment.Principal FindingsTPTest was positive in 39 (27 typhoid and 12 paratyphoid A) patients confirmed by blood culture and was negative in 74 healthy individuals. Among 32 individuals with other illnesses, 29 were negative by TPTest. Of 204 individuals with suspected enteric fever who were negative by blood culture, 44 were positive by TPTest and the patients were clinically indistinguishable from patients with confirmed bacteremia, except they were more likely to be under 5 years of age. We evaluated simplifications in TPTest, including showing that lymphocytes could be recovered using lysis buffer or buffy coat method as opposed to centrifugation, that incubation of cells at 37°C did not require supplemental CO2, and that results were available for majority of samples within 24 hours. Positive results by TPTest are transient and revert to negative during convalescence, supporting use of the test in endemic areas. The results can also be read using immunodot blot approach as opposed to ELISA. Since no true gold standard currently exists, we used a number of definitions of true positives and negatives. TPTest had sensitivity of 100% compared to blood culture, and specificity that ranged from 78–97% (73–100, 95% CI), depending on definition of true negative.ConclusionThe TPTest is useful for identification of patients with enteric fever in an endemic area, and additional development of simplified TPTest is warranted.

Primary renal squamous cell carcinoma is a very rare tumour. Only a few cases have been reported in world literature. Here we report a case with renal squamous cell carcinoma. The patient presented with flank pain, fever and vomiting. In ultrasonography, renal mass was detected and after nephrectomy followed by histopathological examination, it was diagnosed as   squamous cell carcinoma. There was no evidence of renal calculi or other predisposing factors.  This report highlights the rarity of the tumour.   DOI: http://dx.doi.org/10.3329/akmmcj.v3i2.11692   AKMMC J 2012: 3(2): 34-36

Background: This longitudinal descriptive study was conducted for the first time in the department of Pathology, Rajshahi Medical College in order to evaluate the prognostic significance of serum TgAb as a tumor marker for differentiated thyroid carcinoma. Objective: The aim of this study to detect the antibody positive differentiated thyroid carcinoma using serum TgAb and compare with the FNAC and histopathological findings. Method: A total forty patients of clinically, radiologically and by FNAC diagnosed as differentiated thyroid carcinoma were selected attending in the department of Otolaryngology, Rajshahi Medical College Hospital from January 2010 to December 2011. Preoperative serum TgAb level (TgAbl) was measured in all patients taking cut off value as 40 IU/ml. Biopsy material were examined for histopathological diagnosis. 3-6 months after thyroidectomy postoperative serum TgAb level (TgAb2) was measured in those patients only who were TgAbl positive. Result: The correlation, association and statistical analysis of preoperative and postoperative serum TgAb level were computed against histopathological diagnosis. Out of forty cases, 35 were papillary and 5 were follicular carcinoma. Mean age was 25.48+9.70 years and Male: Female was 1:6. In this study, 9 cases (22.5%) were TgAb positive preoperatively and 2 cases showed highest level 3000 and 2200 IU/ml. Post operative TgAb level of 9 cases showed significant reduction. Statistical analysis demonstrates significant correlation (P=<0.01) and association (P=<0.05) between preoperative and postoperative TgAb level. Conclusion: So, it is concluded that serum TgAb level can be used as a tumor marker in antibody positive differentiated thyroid carcinoma.