Accuracy of sonographic features to diagnose malignancy in ovarian cycsts- in a tertiary care hospital Bahawalpur- Pakistan

Ovarian mass is a common clinical problem in reproductive age women, and ovarian malignancy presents late and thus at an advanced stage. That is the reason for its poor 5 year survival despite all advances in gynaecological surgery and oncological chemotherapeutics. It is extremely essential to estimate the risk of malignancy before deciding on the type of surgery for a patient with an ovarian cyst or mass. Objective was determine the sensitivity and specificity of individual sonographic features to predict malignancy in ovarian tumours. It was a cross - sectional study. Clinical and sonographic evaluation of 220 patients presenting with ovarian cysts to Department of Gynaecology, Bahawal Victoria Hospital Bahawalpur was followed by histological examination at Department of Pathology, Quaid-e-Azam Medical College Bahawalpur. We analysed 220 cases of ovarian masses. Mean age of patients was 47.3 +/- 3.8 years. Most common [57.3%] presenting complaint among these patients was abdominal pain followed by distension and palpable mass [21.8% and 19.1% respectively]. On ultrasonography, ecogenicity, papillary projections and multilocularity were commonly observed in malignant cases. Colour Doppler was used to estimate the blood flow. On histopathology, 207 [94.1%] were diagnosed as benign and only 13 [5.9%] as malignant. Among benign, most common diagnoses were follicular / luteal cysts [34.8%] followed by serous cystadenoma [24.6%] and serous cysts [15.4%]. Among malignant, 6 [46.2%] were serous cystadenocarcinoma, 3 [23.1%] were mucinous adenocarcinoma and 2 [15.4%] were granulose cell tumor. Most of ovarian masses are diagnosed as benign. Sonographic features especially increased ecogenicity, solid component, papillary projections, multilocularity and increased blood flow do predict malignant behavior but their sensitivity is low

Association of smoking and low serum bilirubin antioxidant concentrations

Objectives: The objective of this study was to identify the association between cigarette smoking and serum bilirubin antioxidant concentrations

Study Design: A descriptive cross sectional study

Place And Duration: Study was conducted at the Department of Biochemistry at Sheikh Zayed hospital Lahore over a period of one year from January 2012 to December 2012

Methodology: The sample size was sixty with an equal distribution of healthy and control group. Thirty were known smokers and thirty were healthy controls. Thirty smokers who had been smoking for at least five pack years [20 cigarettes per day for one year is equal to one pack year] were included after ruling out coronary artery disease by Exercise Tolerance Test. Same no. of healthy control subjects were selected from general population with no history of smoking, CAD, Diabetes and hypertension

Results:The results of the study have shown that smoking decreases the serum bilirubin concentrations. The mean value of serum bilirubin in 50%[n=30] smokers was 0.59 + 0.034. While in control group 50%[n=30], it was 0.85 + 0.057

Conclusion: From the results, it was concluded that cigarette smoking lowers the bilirubin antioxidant concentration

Bolton tooth size analysis of Pakistanis of 13 to 20 years in Islamabad city

Bolton introduced the anterior and overall ratios that must exist between maxillary and mandibular teeth so as to obtain optimum occlusion. This study was conducted for the purpose of establishing the mean Overall Ratio [OR] and Anterior Ratio [AR] of the Bolton Analysis and the presence of Tooth size discrepancy [TSD] outside 2SD of the Boltoris mean in an orthodontic population, irrespective of -the type of malocclusion. The sample comprised 180pre treatment study casts with fully erupted and complete permanent dentitions from first molar to first molar. Selected randomly from records of the orthodontic patients. The mesiodistal diameters of the teeth were measured at contact points using digital calipers and the Bolton's analysis was carried out. The prevalence of tooth size discrepancies [TSDs] outside of 2 Standard Deviation [SD] from Bolton's mean were 18.8% for the overall ratio and 51% for the anterior ratio. Bolton tooth-size discrepancy is found in large number of Pakistani orthodontic patients which may effect orthodontic treatment goals and outcome. Thus, our results o support that Bolton analysis should be mandatory for every orthodontic case before starting the treatment

Histopathological hepatoprotective effects by echinops echinatus A plant from Cholistan desert

Aerial parts of Echinops Echinotus [EE] were subjected to in vivo histological hepatoprotective study in order to validate its traditional use in hepatobiliary disorders, by native people of Cholistan desert, Pakistan. Experimental study. The study was conducted at PCR lab Multan. The animals were randomly divided into three groups, containing 10 rabbits in each group. Histological hepatoprotective effects of pre-treatment with aerial parts [ethanolic extract] of EE [500 and 750 mg/kg/day PO for 7 days] against CCI[4] [0.75 ml/kg, S/C] intoxicated rabbits were evaluated by liver histological observations. Silymarin [100 mg/kg/day PO for 7 days] was used as a standard hepatoprotective drug. CCI[4] intoxicated group had significant histological changes [marked fatty changes etc.] as compared to normal control group. However, EE extract produced significant histological hepatoprotective changes. Therefore, the outcome of present study supports the traditional behaviour on hepatoprotective effects of Echinops Echinaus [aerial parts]

Evaluation of histopathological and biochemical hepatoprotective potentials of fagonia bruguieri a plant from Cholistan desert

Aerial parts of Fagonia Bruguieri [FB] [family, zygophyllaceae] were subjected to in vivo hepatoprotective study in order to validate its traditional use in hepatobiliary disorders, by native people of Cholistan desert, Pakistan. Experimental study. This study was conducted at PCR lab Multan. The animals were randomly divided into three groups, containing 10 rabbits in each group. Hepatoprotective effects of pre-treatment with aerial parts [ethanolic extract] of FB [500 and 750 mg/kg/day PO for 7 days] against CC1[4] [0.75 ml/kg, S/C] intoxicated rabbits were evaluated by serum biochemical parameters and liver histological observations. Silymarin [100 mg/kg/day PO for 7 days] was used as a standard hepatoprotective drug, CC1[4] intoxicated group had raised levels of SCOT, SGPT and ALP sTignificantly but TB level was not raised as compared to normal control group. FB extract [both doses of 500 and 750 mg/kg] showed hepatoprotection as obvious by significant reinstatement of levels of SCOT, SGPT and ALP while TB level was not changed significantly, when compared with CC1[4] intoxicated group. B[oth] doses of FB extract were well comparable with silymarin. Histopathological examination of the liver tissue further corroborated these results. Therefore, the conclusion of the present study supports the traditional believes on hepatoproptective effects of Fagonia Bruguieri [aerial parts]

Risk factors and microbiologic profile in catheter related urinary tract infection

To describe the consequences of uretheral catheterization in terms of the incidence of catheter related infection, duration of catheterization relation with UTI and changes in microbiologic pathogens. May 2006 to August 2006. Only 214 were included in final analysis, 28 were excluded from the study because these patients expired before the observable endpoint, these were critically ill. Adult patients in whom are indwelling foley's catheter was inserted with past 24 hours at the Emergency Room, Urology Wards, male and female surgical wards, medical wards, orthopedics wards, gynaecology wards, pediatrics wards, neurosurgery wards and ICU of Nishtar Hospital, Multan and Bakhtawar Amin Memorial Trust Hospital, Multan were included in the study. Out of 110 patients who acquired UTI, [83 single bacterial infection, 16 with pure candidal infection, 6 with double bacterial infection and 5 with both bacteria and yeast]. Majority of the isolated organisms were gram negative bacilli [66.9%]. E. coli being the most common [27] followed by Kiebsiella SP [26]. Other gram negative organisms isolated were acinetobactor SP [12], pseudomonas aeruginaosa [8], Enterobactor SP [6] and proteus Sp [2]. Ninteen [15.7%] were gram positive organisms, Enterococcus [9], coagulase negative staphococcus [7] and staphylococcus aureus [3]. Candida spieces were recovered in 17.4% of isolates. Fifty five percent of E. coli were isolated at 2 days post-catheterization while majority of the other organisms were isolated at more than 2 days after catheterization

Comparative study of tramadol and propacetamol for postoperative pain management in patients undergoing nasal surgeries

To compare the analgesic and side effects of propacetamol and tramadol after nasal surgeries. King Abdul Aziz University Hospital, Riyadh [KSA]. From January 2006 to February 2007. A total number of 40 surgical patients were prospectively randomized into two equal groups of 20 and were entered into single blinded clinical trial. Anaethesta. protocol was similar for all patients. Pain intensity was measured based on a 4-point verbal rating scale [VRS]. VRS was obtained before analgesic administration [T0] and at 0.5, 1.5, 3, 4.5, 6, 12, 18 and 24 hours, Patients received either tramadol 100 mg I/V or propacetamol 2 gm I/V at T0 and then 50 mg tramadol or 1.5 gm propacetamol at 6, 12, 18 and 24 hours if pain was present. The results of this study showed that propacetamol is less effective as analgesic in severe pain requiring more supplementary morphine as compared to tramadol. On the other hand tramadol is associated with higher incidence of nausea and or vomiting than with parcetamol. It was concluded from the study that propacetamol is less effective as analgesic in severe pain receiving more supplementary morphine as compared to tramadol

Reference range values of haematological parameters in healthy Pakistani adults

This study has been designed and conducted to establish the normal values of various haematological parameters for healthy adult Pakistani males and females, and to compare these values with those obtained for other populations in both western and tropical countries. This study was under taken in reference adult Pakistani Populations in the area of Multan, Pakistan. A total 302 healthy volunteers whose ages ranged between 20-45 years, were investigated. All laboratory analysis was conducted under standardized conditions at the Haematology Section, Department of Pathology, Bakhtawar Amin Memorial Trust, Hospital [BAMTH] and Multan Institute of Cardiology, [MIC]. In Males, the mean Haemoglobin concentration [Hb] of 13.04 g/dl and Haematocrit [HCT] ratio of 0.39 1/1 were significantly higher than females value of 11.63 g/dl and 0.35 1/1 respectively. The mean Red Blood Cell [RBC] count of 5.3x10[12]/1in males was also significantly higher than the corresponding value of 4x10[12]/1 in females [p<0.05]. The value of Mean Corpuscular Volume [MCV] in males [76.30 fl] was significantly higher than in females [73.84 fl], [p<0.05]. Similarly the Mean Corpuscular Haemoglobin [MCH] and Mean Corpuscular Haemoglobin Concentration [MCHC] were significantly higher in males than corresponding values in females [p<0.05]. On the other hand, the mean White Blood Cell count [WBC] of 8.25x10[9]/1 in males was lower than mean value of 8.42x10[9]/1 in females [p<0.05]. Similarly the values for Platelet count of 255x10[9]/1 in males were also significantly lower than corresponding values of 255x10[9]/1 in females [p<0.05]. This study has established baseline values for haematological parameters in healthy Pakistani adults of Multan and surrounding areas. The sex difference of measured levels of all of these parameters has attained statistical significance. When the observed values of this study were compared with those quoted for the methods in use and those drawn from different populations, significant differences were revealed. Such differences are of accurate clinical interpretation of haematological investigation of patients

Vaccination status against hepatitis b in doctors and final year clinical students working at Khyber college of dentistry and Sardar begum dental college, Peshawar

This is a descriptive study conducted from February, 2006 to april, 2006 The purpose of this study was to assess the vaccination status of dental health care workers at Khyber college of dentistry and Sardar begum dental college Peshawar. Eighty three doctors and fifty six students were interviewed. Sixty seven doctors and forty three students had vaccinated themselves. Sixteen doctors and twenty five students had booster dose of vaccination as well, while seven doctors and six students had checked their antibody level. The commonest reason for non-vaccination was financial factor [cost] and lack of motivation. Two of the participants thought it was not necessary [including one consultant] while seven other participants had other reasons. Among one hundred and thirty nine participants one student and two doctors did not get the 3rd dose of vaccination. Ten students and fifteen doctors had habit of patient screening for HBsAg and anti HCVAb. Sixty five doctors and forty seven students were aware of the importance of antibody titre

Risk factors for hepatocellular carcinoma

Primary hepatocellular carcinoma is one of the most common malignancy in world. It is most common gastrointestinal carcinoma in Saudi Arabia. Liver carcinoma was responsible for 9.1% gastrointestinal cancer in Qassim region. Aim to conduct survey in this region for the rate etiological factors and for other possible causes yet unknown. Out of 24 cases, only 6 were HBsAg positive, 7 anti-HCV positive, only 1 was positive having both HBsAg and Anti-HCV negative. None of the cases were alcoholic. In present study malignancy was slow growing, and there was relatively long survival after diagnosis. Older age group, male predominance and comparatively low levels of AFP were also dominant factors. It is concluded that HCC is one of the common malignancies in southwestern provinces of Saudi Arabia. The prevalence of hepatitis-B and C is also high in these regions

Morphologic variations of malignancies in relation to age, sex and histologic type

Regional differences in the pattern of cancer are obvious in Saudi Arabia. From January 2003 to December 2005 1106 new cases of cancer [642 males, 464 females] were diagnosed in Al-Qassim region. Overall lymphomas, non-Hodgkin's and Hodgkin's disease combined were the most common malignancy seen [15.10%], followed by esophageal carcinoma [7.77%]. Thyroid cancer was the most common malignancy among females [12.5%], followed by breast cancer [9.48%]. The majority of the patients were in the younger age group [77% were < 50 years of age]. Among the hematological malignancies, acute lymphoblastic leukemia was the most frequent type [36.23%]. Lymphomas were also the most common malignancy [66.12%] seen in the pediatric age group [0-14 years], followed by leukemias and brain tumours. The pattern of cancer in Al-Qassim region is generally similar to other regions of Saudi Arabia, with few regional variations. Prominent among such variations is the high frequency of non-Hodgkin's lymphoma [NHL], esophageal and thyroid carinomas