Alopecia Areata - A literature Review

Alopecia areata (AA) is a disease marked by extreme variability in hair loss, not only at the time of initial onset of hair loss but in the duration, extent and pattern of hair loss during any given episode. This variable and unpredictable nature of spontaneous re-growth and lack of a uniform response to various therapies has made clinical trials in alopecia areata difficult to plan and implement. It is a type of alopecia that affects males and females equally. It occurs in both children and adults. The peak age of occurrence is 20 to 50 years .The most common clinical presentation is asymptomatic shedding of telogen hairs followed by patchy non scarring hair loss in association with nail pitting, Beau’s line and nail dystrophy. The disease may progress from this limited presentation to total loss of all scalp hairs (Alopecia totalis) or all body hair (alopecia universalis) with significant onychodystrophy. Mostly it is characterised by reversible hair loss involving the scalp although others areas of head including eyelashes, eyebrows and beard may also be affected. Although, it is a mostly cosmetic problem but it often has devastating effects on quality of life and self-esteem. The paper aims at providing an overview of Alopecia areata.

Ischemic stroke: prevalence of modifiable risk factors in male and female patients in Pakistan

Stroke is the commonest neurological cause of morbidity and mortality all over the world being the third leading cause of death. Estimation of stroke risks in population is not only helpful for healthcare providers but also important to identify persons at elevated risk and to select proper treatments in clinical trials. The aim of the present study was to identify the prevalence of common modifiable risk factors for ischemic stroke in Pakistan. Patients of either sex above the age of 25 yrs who were admitted to Neurology Ward or came to OPD in Jinnah Post Graduate Medical Centre were included in the study. Type of stroke was identified by brain CT scans or MRI and risk factors for stroke and other details were noted on a proforma. Out of 55 patients studied for present study, 78% were males and 22% were females. Most of them belonged to low socioeconomic status and almost 50% were having family history of stroke. Most of the patients had multiple risk factors which included: hypertension [65%], smoking [32%], diabetes mellitus [36.3%], dyslipidemia [32.7%], coronary artery disease [9%], obesity [18%], epilepsy [16.3%] and left ventricular hypertrophy [3.6%]. On the basis of these findings, it can be concluded that hypertension, smoking, dyslipidemia and diabetes mellitus are major risk factors for stroke and might be considered as main targets for primary and secondary prevention of stroke

Clinicopathological analysis of ovarian tumours

To study the relative frequency and histological pattern of ovarian tumours in various age groups. The study was carried out in the Histopathology department, AFIP Rawalpindi from Jan 2002 to Jun 2003 One hundred and ninety four specimens of ovarian tumours were received in Histopathology department, AFIP Rawalpindi. All the surgical specimens were fixed in 10% formalin and routinely processed. The sections were then cut and stained with Haematoxylin and Eosin. The histological typing of ovarian tumours was done according to WHO classification of 2003. The main bulk comprised surface epithelial tumours [73%]. Among them, 107 [75.33%] were benign neoplasms and 35 [24.09%] were malignant. There were 40 [21%] germ cell tumours, 10 [5%] sex cord stromal tumours and 2 [1%] metastatic tumours. The benign category comprised 88 cases of serous cystadenoma, 34 cases of mature cystic teratomas and 19 mucinous cystadenomas. In the malignant group, there were 15 serous cystadenocarcinomas, 10 endometrioid carcinomas, 7 mucinous cystadenocarcinomas, 2 yolk sac tumours and 2 cases of granulosa cell tumour. Benign tumours were mostly diagnosed in 3rd and 4th decades of life, whereas malignant tumours were seen after 40 years, with exception of malignant germ cell tumours, which were mostly found in younger age groups. There were minor differences from local studies. The overall frequency of various tumour groups was very similar to that in the west with some difference in tumour types

autopsy study of hypertrophic cardiomyopathy

To see the pathological features of this disease in our set up and to emphasise the importance of morphological examination in making the diagnosis of hypertrophic cardiomyopathy [HCM] especially in cases of sudden cardiac death. A retrospective, descriptive study of 15 autopsies of this particular disease was carried out at the Armed Forces Institute of Pathology [AFI] Rawalpindi during the period from 1990 to 1995.The hearts along with blood vessels were fixed in 10% formalin and were dissected according to the modified Virchow's method for eliciting the gross appearance of cardiac chambers and valves. Representative sections were taken for histological examination. All the cases were young adult males. The age range was from 17-34 years [mean, 26-6 years] Ten cases died suddenly and five cases had an evidence of moderate to severe exertion preceding their death. Symmetrical as well as asymmetrical hypertrophy was noted in this study. The thickness of inter ventricular septum [mean 20 mm] and left ventricular wall [mean 22.5 mm] was increased. All the specimens revealed disarray of hypertrophic myocardial fibres and patchy interstitial fibroses. Sudden death is usually the first manifestation of disease. The hearts showed asymmetric as well as concentric hypertrophy. Myofibre hypertrophy and disarray was an important pathological findings in our cases. While carrying out post-mortem examination of a case of sudden cardiac death one should also keep in mind the possibility of this disease