Evaluation of Hydrolytic Enzymes among Smokers with Chronic Periodontitis

This study was done to evaluate the level of hydrolytic enzymes ALP and ACP in GCFamong chronic periodontitis patients with smoking habit. Methods: A total of 80 subjects were selected for the study. The study population was further divided into 4 group (Group 1 – clinically healthy periodontium, group – 2 gingivitis, group – 3 periodontitis, group - 4 smokers with periodontitis ). Based on clinical assessment of probing depth , bleeding on probing and radiographic evaluation of alveolar bone loss, GCF samples were taken to assess the level of enzymes. Results: Obtained results shows statistically significant increase in the level of ALP activity in GCF from periodontitis patients with smoking habit. There was positive correlation between the activity of examined GCF enzymes and values of the plaque index, gingival index and periodontal disease index. Conclusion: Based on these results, it can be assume that ALP activity in GCF may be used as potent biochemical markers for periodontal destruction.

Fanconi’s Anemia:

@#Fanconi’s Anemia (FA) is a rare autosomal recessive disorder characterized by thrombocytopenia,diverse congenital malformations which include skeletal malformations, hyperpigmentation, urogenital, renal and cardiac anomalies. We report a case of Fanconi anemia who presented with thrombocytopenia, bilateral hypoplastic thumbs, café-au-lait spots, with severe bleeding from the gingiva managed with platelet transfusion and extraction of the tooth was done

Frequency of osteoporosis in patients with cirrhosis due to hepatitis B and hepatitis C: a study of 100 cases

Osteoporosis is the disease of bone that affected King David of Israel 3000 years ago. This condition is no long considered to be due to aging alone and is increasingly recognized as a major health concern and accounts for about 1.5 million fractures annually in United States. Objective of this study was to see the frequency of osteoporosis in patients with cirrhosis due to Hepatitis B and C, and any correlation between the Bone Mineral Density [BMD] and duration and stage of the liver disease. The study was conducted in the Department of Gastroenterology, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, from January 2008 to December 2008. All patients from the OPD or Ward fulfilling the criteria and consenting were included. Physical examination, with special emphasis on any signs of chronic liver disease was performed. Full blood count, platelet count, prothrombin time and INR, liver function tests including serum albumin, and renal function tests were done on all patients. Viral serology was checked for those patients who were either newly diagnosed as cirrhotic or were cirrhotic but not screened for viral markers. Abdominal sonogram was recorded on all patients. The child's score was calculated for each patient using the clinical and lab parameters. The BMD was calculated for all patients using computer based ultrasound probe. Calcaneum was used for evaluation of BMD. The information collected was entered on structured data collection sheets and was analysed using SPSS version 11. Osteoporosis was found in 26% of subject and osteopenia in 42%, while 32% had BMD in the normal range. The mean T score was -1.483 [ +/- 1.29]. The mean duration of liver disease was 3.77 [ +/- 1.56] year. Majority of the patients [81%] were in Child's Class C, followed by Class B and A [16% and 3% respectively]. Fifty-nine percent of the patients were males with a mean age of 37.65 years, while 41% were females with mean age of 37.76 years. Osteoporosis is a common finding in patients with cirrhosis due to Hepatitis B and C. Osteoporosis is more frequent in patients with long duration of liver disease but there is no significant correlation between the aetiology or severity of liver disease and osteoporosis

role of young population structure in determining age distribution of breast cancer in Jordan

Previous reports noted a high proportion of young Jordanian breast cancer [BC] patients. This study was performed to find whether this is reproducible and to examine the role, if any, of a young population structure in causing this. We hypothesized that the age distribution [AD] of BC in Jordan is independent from the population structure. By finding that the AD of BC in a model population, where the population structure of Jordan is similar to the USA, was significantly different [P = 0.01] from the observed AD in Jordan, we rejected this hypothesis. We conclude that a young population structure, as well as a low incidence in older patients, are the main reasone behind a high proportion of young patients with BC in Jordan. This may also be valid in other countries having an early onset/low incidence rate of BC

Lansoprazole in severe gastro-oesophageal reflux disease [GERD]

Lansoprazole is a new proton pump inhibitor which produces prolonged decrease of gastric acidity. It has been used in severe gastro-oesophageal reflux disease with beneficial effect. We confirmed the efficacy of Lansoprazole in severe [grade IV] reflux esophagitis at the dosage of 30mg daily for 3 months. All patients had symptomatic response after 2 to 6 weeks of therapy. Endoscopically 90% of patients had complete healing of reflux esophagitis at 12 weeks. This indicates that at conventional dosage of 30 mg daily Lansoprazole gives good symptomatic and endoscopic response in patients with gastro-oesophageal reflux disease who failed to improve with H2 receptor antagonists

Parasitic infection among primary school children in Tikrit city

A survey of the prevalent parasitic infection in school children in Tikrit city was conducted in 1992. A cross-section, multistage, random sample size of 440 primary school children was selected. The prevalence of infection was 19.8%. Seven different species of parasites were diagnosed. Hymenolipes nana ranked first [35.3%], then followed by Entamoeba histolytica [23.3%], and Giardia lamblia [16.8%]. The relationship between sex, age group, socioeconomic status, parents educational level and other factors were also studied

Experience in coronary surgery with left main stem stenosis over thirty two months

Among 555 patients who underwent Coronary Artery Bypass Grafting [CABG] from January 1992 to August 1994, 48 [9%] patients had Left Main Stem Stenosis [LMS]. There were 45 [94%] males and 3 [6%] females with a median age of 52.3 [40-72] years. Patients were divided into three groups with respect to the degree of severity of LMS, Group I greater than 90% stenosis, fourteen [29.2%] patients, Group II 50-89%, twenty nine [60%] patients, Group III less than 50%, five [10%] patients. Ejection fraction was greater than 40% in twenty three [48%] patients, and less than 40% in thirteen [27%] patients, no record was available in twelve [25%] patients. Pre operatively there were eight [17%] patients in New York Heart Association [NYHA] Class II, thirty five [72%] in Class III and five [10%] in Class IV. Exercise duration was short and ST depression with typical angina was observed in many leads in stage I and early stage II. Six [12%] patients underwent emergency surgery, twenty seven [57%] and fourteen [29%] patients underwent urgent and elective surgery respectively. The interval between coronary Angiography and Surgery in the urgent group was mean of 6.9 [1-14] days

Coronary artery bypass surgery with minimal use of homologous blood using a cardiotomy reservoir

This study was conducted to evaluate a simple and inexpensive blood conservation program using a hard shell cardiotomy reservoir. Design: It was conducted involving 60 patients who had coronary artery bypass grafting [CABG]. Setting: Cardiac Surgery Unit, PIC [Punjab Institute of Cardiology, Lahore]. 60 consecutive cases of IHD between the ages of 30-60 years admitted for CABG in Punjab Institute of Cardiology, Lahore. Main outcome measures: To conserve shed autologous blood and observe advantages/disadvantages of its re-transfusion and its comparison with control patients who received homologous blood. Patients characteristics were similar in both groups, the intra-operative blood loss was similar in both groups. The post-operative blood loss was significantly less in the group where re-transfusion of shed blood was performed than in the control group. The total requirement of homologous blood product was significantly less in patients where auto-transfusion was used. Use of auto-transfusion is cheaper and safer way to replenish blood during open heart surgery

Total arterial revascularization of the heart using both internal mammary arteries and right gastroepiploic artery

The internal mammary artery is widely recognized as the graft of choice for coronary artery bypass grafting. This study was conducted to demonstrate an alternate conduit with adequate long term patency. Design: Retrospective study of six patients who underwent complete arterial revascularization. Setting: Cardiac surgery unit, Punjab Institute of Cardiology, Lahore. Six patients between ages of 32-38 who underwent coronary artery bypass grafting. Main outcome measures: Younger age group patients with ischaemic heart disease who underwent CABG, safety, short and long term results of all arterial grafts. All these six patients had total revascularization using both IMA's and RGEA. All six patients had RGEA anastomosed to RCA or its branches mainly PDA. Operation time was longer than normal. Postoperative blood loss was comparatively larger [average 800 +/- 50 ml]. None of the patients had signs of perioperative.ischaemia. One patient was reopened for bleeding. Average stay in hospital was 10 days. All patients had negative ETT except one whose ETT was positive at peak exercise. Three patients were restudied at three months which showed all potent grafts. Two patients were again restudied at one year interval and again all grafts were potent. No patients were readmitted to the hospital. Use of right gastroepiloic artery is safe and effective in total arterial revascularization