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Background:The 5-methyltetrahydrofolate-homocysteine methyltransferase gene (MTR) encodes the methionine synthase enzyme (OMIM 156570). Methionine synthase synthesizes methionine by re-methylation of homocysteine. A single nucleotide variation MTR-A2756G may affects the function of methionine synthase enzyme, which could lead to the development of head and neck squamous cell carcinoma (HNSCC).Methods:In current study, 292 HNSCC patients and 324 normal individuals without any history of cancer (control) were enrolled. EDTA whole blood samples of patients and control individuals were collected, and DNA was extracted. All samples were genotyped for MTR-A2756G polymorphism using polymerase chain reaction-restriction fragment length polymorphism. Frequency of polymorphism was compared between HNSCC patients and control individuals. The association of MTR-A2756G polymorphism with risk factors was statistically analysed through multivariate analysis (multiple logistic regression) whereas univariate analysis (chi square) was performed for group comparisons.Results:Univariate analysis revealed that the frequency of groups like age, smoking and MTR-A2756G genotype was different in HNC patients and controls (p value <0.05). Multivariate analysis showed that smoking (adjusted OR, 3.7; 95% CI, 2.3-6.0), age groups 41-50 years (adjusted OR, 3.6; 95% CI, .9-6.7) and >60 years (adjusted OR, 3.5; 95% CI, 1.7-7.3), MTR-A2756G genotype (adjusted OR, 2.1; 95% CI, 1.3-3.5) is associated with increased risk of HNSCC.Conclusions:Our data suggests that the MTR-A2756G polymorphism is associated with the occurrence of HNSCC in Pakistani population while the individuals between 40 to 50 years of age and tobacco smokers are at a greater risk of developing HNSCC.
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Objective: To compare the effectiveness of steroid therapy with and without physiotherapy for the management of lateral epicondylitis (tennis elbow). Methodology: Patients, who fulfil the inclusion criteria of selection were admitted to study in the Department of Physiotherapy PSRD, Lahore. Each patient received an informed consent. Demographic data including name, age, sex, height and weight were noted. Participating individuals were randomly allocated into two groups by lottery method. Patients of group A were treated by steroidal therapy without physiotherapy manoeuvres and the individuals of group B were treated by combination of steroidal therapy and physiotherapy. The follow-up was carried out for up to 4 weeks.All the information has been collected with pre-defined preforms.Data was interpreted and analysed through SPSS version 22.0. Results: The overall mean age of cases was 38.90±6.97 years and 42.07±7.03 years. There were 38(63.33%) male and 22(36.67%) female in this study. Before treatment the mean pain of participating individuals of group-A and in group-B was 7.40±1.45 and 7.63±1.27 with insignificant difference. After treatment the mean pain in group-A and group-B was 3.40±1.73 and 2.53±1.57 with significantly lower pain in group-B, p-value < 0.05. When we compared mean pain before and after injection was significantly improved in both groups but the improvement was higher in group-B. The mean pain difference in group-A and group-B was 3.77±2.18 and 4.90±1.83 with higher improvement in group-A, p-value < 0.05. Conclusion: Results of study concludesteroid injection with addition to physiotherapy was more effective in reducing pain.We must encourage orthopedic and physiotherapist teamwork to treat tennis elbow.
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Background and Objectives: Epilepsy which is a disorder with an extensive variability of symptomatology and multifactorial origins is categorized by emergent and recurrent seizures. Numerous studies showed that seizures are triggered by hyperactivity of the neurons of the brain which may be atypical and synchronous. Our study was aimed to find out the association of inflammation in terms of total leukocyte count (TLC) and serum creatine phosphokinase (CPK) concentration in epilepsy and their comparison with pseudo-seizures and healthy controls. Methodology: We conducted this study in Mayo Hospital, Lahore with the collaboration of the Physiology Department of King Edward Medical University, Lahore after approval from Advanced Studies and Research Board of KEMU, Lahore. The sample size was ninety and they were divided equally into three groups, 30 patients of GTCS, 30 patients with a history of pseudoseizures and 30 healthy subjects of comparable age. p< 0.001 was taken as significant. Statistical analyses were done using SPSS 21. Results: Mean total leukocyte count (TLC) in Pseudo-seizures groups was 8216.3 ± 2195.8 cu.mm, in the epileptic group was 13219.9 ± 2686.8 cu.mm and in the control group, the mean TLC was 6832.1 ± 1154.9 cu.mm. Mean serum CPK in pseudo-seizure groups was 130.1 ± 74.3 IU/100 ml, in the epileptic group was 257.7 ± 24.6 IU/100 ml and in the control group, the mean CPK was 79.9 ± 27.7 IU/100 ml. Conclusion: Total leukocyte count (TLC) and CPK were higher in the epileptic group as compare to the pseudo-seizure groups as well as the control group. Elevated WBC levels may be a result of continuing inflammatory progressions in the pathogenesis of epilepsy. Therefore it was concluded that serum CPK and TLC may serve as a differentiating marker between epileptic generalized tonic-clonic seizures (GTCS) and pseudo seizers.
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Background: Tobacco use is one of the biggest public health threats the world has ever faced. There are more than one billion smokers in the world. Almost half of the world's children breathe air polluted by tobacco. Aim of current study was to study the smoking trends among young doctors in a tertiary care institute in north India. Methods: A descriptive observational cross-sectional epidemiological study was conducted among 250 doctors of a tertiary care Hospital in Jammu & Kashmir (Sheri Kashmir Institute of Medical Sciences, SKIMS) during the two months of February-March, 2014. The predesigned tool adopted during data collection was a questionnaire that was developed at the institute with the assistance from the faculty members and other experts. Results: Among 250 participants, (20%) were smokers; among smokers, (76%) were regular smokers and (24%) were occasional smokers. Majority of smokers were in the age group of 21-30 years (80%) & started smoking between 11-20 years (70%). All of them were male (100%). No significant difference was observed among urban and rural students. Among smokers, majority (60%) was in the practice of smoking for last 6 months to 1 year and 26% smoked for <6 months; & (14%) smoked for more than 5 years .It was found more than half of the responding (60%) students used to smoke 5-9 cigarettes per day; 14% is <5 and 26% consumed 10 or more per day .Among smokers, peer pressure was found in 80% cases. (χ2 = 107, P <0.001). Among smokers, almost 20% had other addiction and among non-smokers only 5% had .Effect of parental smoking was significantly higher in smokers than non-smoker (χ2 = 66.2, P <0.001) .It was seen that peer pressure was the most important risk factor (60%) of initiation of smoking habit followed by parental influence (20%). Majority (78.4%) had no intention to quit in the next 6 months. Lack of Incentive (36.36%) and Addiction (27.27%) were the main reasons for not quitting. Conclusion: We need to create more awareness regarding hazards of smoking in general population especially in medical students, and afterwards provide psychological and pharmacological support for those who intend to quit, as medical students can themselves become a tool to fight this hazard at all levels.
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Pelvic osteotomy for acetabular dysplasia has been introduced to improve acetabular coverage of the femoral head and reduce the risk of secondary osteoarthrosis. Several surgical methods for acetabular reorientation have been proposed for this purpose by reorientation of the acetabulum single, double, triple, spherical and periacetabular osteotomies. We report our first experience with periacetabulur berneese osteotomy described by Prof. R. Ganz and now the procedure of choice in appropriately selected patients. Fifteen years old boy who presented with complaints of fall and pain in the right gluteal region for 5 days duration that increased with walking. Examination revealed an antalgic gait. Rest of his examination was normal except mild tenderness in the right buttock area. His plain X-rays revealed an incidental finding of dysplastic left hip with deficient lateral coverage, deformed femoral head, coxa magna and mild coxa valga. In addition he had focal arthritic changes over the superolateral acetabulam with sclerosis and cyst formation. His anterior center-edge angle was 24 degrees with an acetabular index of 44 degrees. He had grade II arthritic changes according to the Tonnis classification of osteoarthritis. A periacetabulur ganz osteotomy was performed.Correction was confirmed with intraoperative X-rays. His post operative course was smooth and he was allowed full weight bearing at 8 weeks when X-rays showed satisfactory healing of osteotomy