Concurrent outbreaks of circulating vaccine-derived poliovirus types 1 and 2 affecting the Republic of the Philippines and Malaysia, 2019-2021.

Concurrent outbreaks of circulating vaccine-derived poliovirus serotypes 1 and 2 (cVDPV1, cVDPV2) were confirmed in the Republic of the Philippines in September 2019 and were subsequently confirmed in Malaysia by early 2020. There is continuous population subgroup movement in specific geographies between the two countries. Outbreak response efforts focused on sequential supplemental immunization activities with monovalent Sabin strain oral poliovirus vaccine type 2 (mOPV2) and bivalent oral poliovirus vaccines (bOPV, containing Sabin strain types 1 and 3) as well as activities to enhance poliovirus surveillance sensitivity to detect virus circulation. A total of six cVDPV1 cases, 13 cVDPV2 cases, and one immunodeficiency-associated vaccine-derived poliovirus type 2 case were detected, and there were 35 cVDPV1 and 31 cVDPV2 isolates from environmental surveillance sewage collection sites. No further cVDPV1 or cVDPV2 have been detected in either country since March 2020. Response efforts in both countries encountered challenges, particularly those caused by the global COVID-19 pandemic. Important lessons were identified and could be useful for other countries that experience outbreaks of concurrent cVDPV serotypes.

SEVERITY OF THROMBOCYTOPENIA IN PATIENTS WITH PLASMODIUM VIVAX MALARIA; A SINGLE CENTER STUDY.

BACKGROUND: Thrombocytopenia has been frequently observed in plasmodium vivax malaria in different studies. Finding out the severity of thrombocytopenia--is perhaps equally important, as it has practical as well as prognostic implications. The objective of the study was to assess the severity of thrombocytopenia in patients suffering, from malaria caused by plasmodium vivax. METHODS: This cross-sectional study was carried out at Combined Military Hospital (CMH) Malir, Karachi, which is a tertiary care Hospital for all military personnel & their families in the province of Sindh. All patients of smear positive Vivax malariaduring the study period were, included, and those having thrombocytopenia from any other reason were excluded. They were treated with antimalarial drugs and their platelet counts were monitored till they normalized and discharged from the hospital. Thrombobytopenia was defined as platelets count of <150,000/cu mm. Results were. analysed by SPSS 11. RESULTS: Out of 150 cases, 133 (88%) had thrombocytopenia. Their ages ranged from 15 to 55; mean age was 35 with SD +/- 20. Low platelet count observed was between 11,000 and 146,000/cu mm with SD +/- 27404. Mean value was 79,832/cu mm. None of the patient had any bleeding episode requiring a blood transfusion. CONCLUSION: Plasmodium vivax associated thrombocytopenia has a benign outcome. irrespective of severity of the platelet counts.

Correlation of human epidermal growth factor receptor 2 (HER-2/neu) receptor status with hormone receptors Oestrogen Receptor, Progesterone Receptor status and other prognostic markers in breast cancer: an experience at tertiary care hospital in Karachi.

OBJECTIVE: To determine the frequency of human epidermal growth factor receptor 2 (HER-2/neu) positivity and to correlate its status in breast cancer patients with other prognostic markers. METHODS: The comparative cross-sectional study was conducted at the Department of Histopathology, Liaquat National Hospital, Karachi, from January 1 to October 31, 2010. It included all specimens of mastectomy and lumpectomy with axillary tissue. Incisional, trucut and wedge biopsies as well as all non-epithelial tumours were excluded. All samples were processed as per standard guidelines and were evaluated by immunohistochemistry. SPSS 10 was used for statistical analysis. RESULTS: The age of the 100 cases in the study ranged from 20 to 82 years with a mean of 51+/-17.6 years. Two (2%) of the patients were males. HER-2/neu over-expression increased with increasing tumour size, grade, lymph node metastasis and with oestrogen receptor and progesterone receptor negativity. No significant correlation of HER-2/neu was seen with the age of patient and with the tumour type. CONCLUSIONS: The expression of HER-2/neu was associated with decrease in oestrogen receptor and progresterone receptor positivity, and increase in tumour size, high tumour grade and lymph node metastasis.

Primary angiosarcoma of breast.

Primary breast sarcomas, except for phyllodes tumour, are very rare entities, accounting for < 0.1% of all malignant neoplasms. Angiosarcoma of breast is infrequent malignancy and differential diagnosis from other sarcomatous and angiomatous breast tumours holds importance. Two cases of primary angiosarcoma of breast were encountered. One involved a 32 years lady who was treated by wide local excision and six cycles of chemotherapy. The other occurred in a 54 years old lady who was treated with mastectomy, did not receive any radiation or chemotherapy and was later lost to follow-up. Neither of the patient had history of previous breast surgery, chemotherapy or radiotherapy.

Frequency of precancerous lesions in endoscopic gastric biopsies in chronic gastritis.

OBJECTIVE: To determine the frequency of precancerous lesions in endoscopic gastric biopsies of patients with chronic gastritis. STUDY DESIGN: A case series. PLACE AND DURATION OF STUDY: Department of Histopathology, Liaquat National Hospital, Karachi, from July 2008 to January 2009. METHODOLOGY: Over 6 months, 375 endoscopic gastric biopsies of patients with age group of 15-65 years having endoscopic chronic gastritis were included. From final biopsy report, basic information like patient demographics and presence of precancerous lesions i.e. activity (chronic active gastritis), atrophy (atrophic gastritis), intestinal metaplasia and dysplasia were recorded on proforma. Results were described as proportions and frequency. RESULTS: The frequency of precancerous lesions in endoscopic gastric biopsies of patients with chronic gastritis in Karachi was markedly high. Most common lesion was chronic active gastritis as depicted by activity (48.3%); dysplasia (1.3%) was the least common. Proportion of more aggressive precancerous lesions were markedly higher in older age group (> 40 years). CONCLUSION: The precancerous lesions are frequent in endoscopic gastric biopsies of patients with chronic gastritis.