ABSTRACT
The anatomical pathology autopsy serves several purposes, notably as a quality management tool for evaluation of accuracy in clinical diagnosis. Despite its value, for various reasons there has been an international decline in autopsies conducted. In the modern medical era, with all its advances in technology, diagnostic techniques and interventions, there is still a high discrepancy between clinical diagnoses and postmortem findings.Objectives. To establish the discrepancies between clinical diagnoses and postmortem findings in anatomical pathology autopsies.Methods. A retrospective, descriptive study was conducted over the 4-year-period 2014 - 2017. The clinical diagnoses and postmortem findings of cases referred to the Department of Anatomical Pathology at the University of Pretoria, South Africa, were evaluated and compared using the modified Goldman criteria.Results. A total of 288 cases qualified for the study and were evaluated. The gender distribution was 155 (53.8%) male and 133 (48.2%) female, with the majority of cases in the age group 19 - 60 years (mean 36.4). The majority of the cases were referred by internal medicine, followed by paediatrics. The most common cause of death in major missed diagnoses was pulmonary conditions. Of the cases, 115 (39.3%) had a major discrepancy and 62 (21.5%) a minor discrepancy.Conclusion. This study showed that there is still a high discrepancy between clinical diagnoses and postmortem findings, similar to studies conducted globally. The current COVID-19 pandemic may be a driver for revival of the anatomical pathology autopsy, and future studies are recommended to evaluate whether the decline can be reversed
Subject(s)
Humans , Pulmonary Atelectasis , Clinical Laboratory Techniques , Pathology , Autopsy , Comparative StudyABSTRACT
Aim: To determine the salmonellae serovars circulating in North Central Nigeria and their treatability with commonly used antimicrobial agents. Study Design: Investigative Place and Duration of Study: Samples were collected and processed at the Jos University Teaching Hospital (JUTH), Plateau State, Nigeria between 2006 and 2011. Methodology: Standard microbiological tests were used for isolation, identification and serotyping of salmonellae from 3509 blood and 5426 stool samples collected from patients attending Jos University Teaching Hospital (JUTH), Jos between 2006 and 2011. Identified serovars were subjected to antimicrobial susceptibility testing using disc diffusion method. Results: 89 Salmonella isolates were obtained from 8935 samples. Blood and stool cultures yielded 1.4% and 0.70% salmonellae respectively. The highest number of isolates was from age group 0-9 years 30(33.7%) while patients aged 70 and above accounted for the least number of isolates 1(1.1%). Males accounted for more isolates 49(55.1%) than females 40(44.9%) (p<0.05). The 89 isolates encountered comprised 39 serovars of which 74(83.1%) were non-typhoidal. Frequently isolated serovars were S. typhimurium and S. bargny 11(12.3%) each, S. typhi 7(7.7%) and S. paratyphi B and S. saint Paul 6(6.7%) each. Rare serovars isolated included S. Lagos, S. aba, S. kisii, S. okerara and S. aminatu 1(1.1) each. All isolates were susceptible to ciprofloxacin and ceftriaxone( MIC≤ 1μg/mL) while more than 50% of the frequently isolated serovars were resistant to chloramphenicol, amoxicillin and cotrimoxazole. Conclusions: This study reveals a high occurrence of invasive non-typhoidal, multi-drug resistant Salmonella serovars. However, susceptibility to ciprofloxacin and ceftriaxone is completely preserved and can be used for empirical treatment of salmonellosis.
ABSTRACT
Aim: To determine the salmonellae serovars circulating in North Central Nigeria and their treatability with commonly used antimicrobial agents. Study Design: Investigative Place and Duration of Study: Samples were collected and processed at the Jos University Teaching Hospital (JUTH), Plateau State, Nigeria between 2006 and 2011. Methodology: Standard microbiological tests were used for isolation, identification and serotyping of salmonellae from 3509 blood and 5426 stool samples collected from patients attending Jos University Teaching Hospital (JUTH), Jos between 2006 and 2011. Identified serovars were subjected to antimicrobial susceptibility testing using disc diffusion method. Results: 89 Salmonella isolates were obtained from 8935 samples. Blood and stool cultures yielded 1.4% and 0.70% salmonellae respectively. The highest number of isolates was from age group 0-9 years 30(33.7%) while patients aged 70 and above accounted for the least number of isolates 1(1.1%). Males accounted for more isolates 49(55.1%) than females 40(44.9%) (p<0.05). The 89 isolates encountered comprised 39 serovars of which 74(83.1%) were non-typhoidal. Frequently isolated serovars were S. typhimurium and S. bargny 11(12.3%) each, S. typhi 7(7.7%) and S. paratyphi B and S. saint Paul 6(6.7%) each. Rare serovars isolated included S. Lagos, S. aba, S. kisii, S. okerara and S. aminatu 1(1.1) each. All isolates were susceptible to ciprofloxacin and ceftriaxone( MIC≤ 1μg/mL) while more than 50% of the frequently isolated serovars were resistant to chloramphenicol, amoxicillin and cotrimoxazole. Conclusions: This study reveals a high occurrence of invasive non-typhoidal, multi-drug resistant Salmonella serovars. However, susceptibility to ciprofloxacin and ceftriaxone is completely preserved and can be used for empirical treatment of salmonellosis.