Seroprevalence of measles antibodies in school going children in Pakistan

To determine the Seroprevalence of measles IgG antibodies in school going children [age 4 to7.5 years] and assess the need for second dose of vaccination. Study type, settings and duration: National study in randomly selected primary school children for a duration of 12 months. Subjects and Methods: A national representative sample of 6000 school going children between 5-7 years of age was taken out. As 500 children were already studied an year before in Islamabad, therefore, 2500 children from Punjab, 2000 from Sindh and 500 each from Khyber Pakhtonkhaw and Balochistan making a total of 6000 children. These children were selected from major cities of Pakistan that included Peshawar, Lahore, Multan, Faisalabad, Karachi, Hyderabad, and Quetta. Consent was taken from the parents and principals of the schools for collection of blood samples. About 5 ml of whole blood was taken from which serum was separated and stored for testing. Measles antibody titres [serum IgG antibodies] were measured by enzyme-linked Immunosorbant assay [ELISA]. Antibodies concentration<200 m IU was considered negative [non-protective]; those having levels between 200-300 m IU were labeled as border line and>300 m IU as positive [protective]. For the purpose of analysis, ages of the children were divided into three groups

Frequency of campylobacter jejuni in diarrhoea/dysentery in chidren in Rawalpindi and Islamabad

To determine the frequencyof Campylobacter jejuni infection in children suffering from diarrhoea/dysentery in the Department of Microbiology, Army Medical College and Military Hospital, Rawalpindi, from 29 August 2002 to 29 November 2002.The study was carried out on one hundred stool samples of children up to the age of twelve years admitted with diarrhoea/dysentery in Military hospital, Rawalpindi. The samples were collected in clean polypropylene containers containing Cary Blair medium. These were transported to the Microbiology Department, Army Medical College, Rawalpindi within 1-2 hours. The samples were inoculated on Modified Preston [Oxoid] and Karmali media [Oxoid] beside other routine stool culture media. The cultures were incubated at 42oC under microaerophilic conditions. The growth after 48 hours was provisionally identified by colonial morphology, oxidase test, Gram staining and motility. The organisms were identified to species level by hippurate hydrolysis, urease test, nitrate reduction, catalase test, H2S production and resistance to cephalothin.Eighteen% of samples yielded the growth of Campylobacter jejuni. Mean age of children with Campylobacter jejuni infection was 18 months with peak incidence from 12 to 21 months. Male female ratio was 1.7:1. All the children had loose motions. Seven out 18 [39%] had a combination of symptoms of loose motions, vomiting and pain abdomen. Those having fever with or without other complaints constituted 11 out of 18 [61.11%] i.e. more than 50% of all the children yielding C. jejuni had fever. About 90% of diarrhoeal stools had blood and fifty% also had mucous. There was either history of chicken meat consumption or contact with cattle and pets in most of the cases and both in some of them.Campylobacter jejuni is a frequent cause of diarrhoea/ dysentery in children in our set up. In children it is often related to pets keeping and chicken meat consumption. In the remaining, untreated drinking water may be the source. Campylobacter jejuni frequently presents with blood and mucous in stools with sporadic cases presenting with watery diarrhoea

Prognostic factors in stage-I breast cancer: a retrospective study

We studied the case records of all patients presenting with stage-I breast cancer [tumour < 2 cm, no axillary nodes or distant metastases]. All clinical and pathological features were evaluated and findings were correlated with short term treatment failures [local and distant recurrences within 2 years]. An early recurrence was seen in 28% patients. There was no significant differences in the mean age at presentation [44 vs 47 years] or menopausal status [8 Vs 7 years]. Estrogen receptor status was unknown in all the patients. A positive family history of breast cancer was noted in 40% women with tumour relapse against 6% in the non-relapsed group. Associated fibrocystic mammary dysplasia was found in 80% relapsed cases whereas 60% showed lymphatic invasion and tumour necrosis. Vascular invasion was reported in 40% cases. A poorly differentiated histology fibrocystic mammary dysplasia, lymphatic and vascular invasion and tumour necrosis were poor prognostic factors. It was concluded that adjuvant chemotherapy should be given to all patients presenting with stage-I breast cancer and showing poor prognostic factors regardless of the menopausal status

Two patients with dysgerminoma ovary

Dysgerminoma is a rare malignant germ cell tumour of the ovary. This accounts for about 2-5% of all primary malignant ovarian tumours. In this article two case reports are presented. Case-I is that of a young girl who was diagnosed as stage-IV dysgerminoma ovary and was treated with conventional chemotherapy [VAC regimen - Vincristine, Actinomycin-D and cyclophosphamide]. She went into complete remission after 8 months of treatment. The treatment was continued for one year. Case-II is of a young lady who presented with malignant pleural effusion, and huge abdominal recurrence of a dysgerminoma ovary. She received four cycles of PEB regimen - [Cisplatinum, Etoposide and Bleomycin]. She is now in complete remission. Purpose of this discussion is to emphasize that germ cell tumours are highly chemosensitive and curable even in advanced stages

Radiotherapy of cervical cancer: experience with combined brachytherapy and external beam therapy

Invasive cancer of cervix is diagnosed in about 8% of women presenting with malignancy in Pakistan. A significant number of patients present with advanced cancer. These patients are usually treated with combined external beam and intracavitary radiotherapy. Out of the 444 patients included in this study, 2% were in stage I-A, 8% in stage I-B, 24% in stage II-A, 20% in stage II-B, 38% in stage III and 8% in stage IV-A. Two percent patients were in stage IV-B. All of these patients with stage I-A were free of the disease at 2-5 years after radiotherapy. 80% of stage I-B, 75% of stage II-A, 50% of stage II-B and 16% in stage III are still free of local recurrence after 2-5 years of follow up. Patients in stage IV-A could not achieve long term local control with radiotherapy alone. Ten percent of the patients in stage I-B developed distant metastases, 22% of stage II-A, 20% of stage II- B and 19% of stage III developed distant metastases. Local control as well as disease free survival was good in limited disease and local control with radiotherapy alone was poor in locally advanced stages II-B - N- A cancer cervix. Better pelvic control was observed with concomittant chemo-radiotherapy in such patients. Neo adjuvant chemotherapy with Cis-platinum containing regimens is currently being utilized in patients with poor prognostic factors. This strategy is expected to provide long term controls and improved disease free survival rates

Incidence of gall stone disease, a hospital based study

Three hundred patients with gall stone disease admitted in Surgical Unit-1 Nishtar Hospital, Multan during a period of 6 years [January 1986 to December 1991], have been studied. Twenty-five were male [8.3%] while 275 were female patients [91.7%]. The male to female ratio was 1: 11. Peak incidence was between 30-50 years of age. Ninety patients presented with pain right hypochondrium [30%] and 54 with flatulent dyspepsia [18%]. Twenty-seven patients presented with acute cholecystitis [9%]. Thirteen patients presented with obstructive jaundice [4.3%]. Most of the patients had chronic cholecystitis [37%]. Fifteen patients had carcinoma of the gall bladder [5%]. Eighty-two% of the stones on analysis proved to be cholesterol stones while only 18% were pigment stones. Ultrasound was found accurate in 86% while Oral Cholecystography was accurate in 73% of the patients

Radioaerosol mucociliary clearance of tracheobronchial tree in normal subjects and in patients with respiratory diseases

The rate of mucociliary clearance in the tracheobronchial tree was studied both in patients and controls using radioisotopic techniques. The radioisotope is deposited in the larger airways and its rate of movement is measured as it is being transported up the trachea due to mucociliary activity. The BARC aerosol generation system was modified and used for this purpose. One hour study was acquired on a computerised gamma camera in each case. The rate of movement of the bolus of radioactivity was calculated by measuring the distance travelled in a known period of time. The mean velocity of transport was 9.0mm/min in normal subjects. In patients variable speed of transportation was obtained ranging from absolutely no movement to near normal speeds. Different patterns of transport were observed including linear, spiral, static and regurgitative. It was concluded that this simple non-invasive technique can be used for in vivo monitoring of mucociliary tracheal activity

Radio aerosol pulmonary imaging in COPD

Ninty five patients of chronic obstructive pulmonary disease [COPD] were subjected to radio-aerosol lung imaging to evaluate ventilatory function of the lungs, which was followed by lung profusion scanning. The patients were picked up randomly and the conventional ventilation studies were also done in addition to lung function tests and chest roentgenograms. The apparatus used was provided by the International Atomic Energy Agency. It generated aerosol particles of Tc-99m DTPA of pressure/vacuum air pump. Out of these 95 patients, 37 cases were those of bronchial asthma, 38 of chronic bronchitis, 5 of bronchietasis, 4 of chronic bronchitis with asthma, 3 with chronic bronchitis with emphysema, 2 with emphysema with bronchietasis and 6 were those of emphysema, Six normal subjects were taken as controls, A comparative study of all the performed lung function tests was done, We were able to detect defects of radio-aerosol pulmonary distribution even in those cases, where other lung function tests were not so conclusive. We conclude that the radio-aerosol pulmonary scanning is a very sensitive test and could be a valuable aid in diagnosis and follow up of cases of COPD

Beneficial effect of zinc on experimental myocardial infarction

The effect of zinc on isoproterenol induced myocardial infarction was studied in rats. Male albino rats were pretreated with 5 mg/kg body weight of zinc [22 mg Zn SO4], intraperitoneally on 15 consecutive days. The same animals were given 80 mg/kg of isoproterenol subcutaneously on 14th and 15th days of the study. After 48 hours of isoproterenol, ECG was recorded; the animals were killed and blood, heart and adrenal glands were removed for biochemical studies. ECG and biochemical studies suggest a more beneficial effect of supplementation of zinc on experimental myocardial infarction. The possible mechanism of action has been discussed

Protective effect of andrographis paniculata nees, on experimental liver damage

The present investigation was undertaken to study the effect of Andrographis paniculata Nees, in experimental liver damage in rats. The liver necrosis was produced by an intraperitoneal injection of carbon tetrachloride [0.3 ml/100 gm body weight], the aqueous extract of Andrographis paniculata [100mg/100 gm body weight of rats] was administered orally on three consecutive days before administration of carbon tetrachloride. Eighteen hours after the carbon tetrachloride injection, the animals were sacrificed and liver, blood and adrenal glands were collected for histopathology and biochemical examination. Biochemical parameters included liver glycogen, serum enzymes [SGOT and SGPT], serum free acids, blood urea and bilirubin. Adrenal ascorbic acid was also investigated to assess the severity of stress in treated and untreated animals. The result of histopathology of liver and biochemical parameters suggested a significant protective effect of extract in the experimental liver damage. Studies on adrenal ascorbic acid showed that the animals pretreated with drug suffered less stress as compared with the untreated animals