Risk profile for breast carcinoma and tumour histopathology of medical uninsured patients in Pakistan

Breast carcinoma is an unpredictable disease in the sense that some patients may die at early disease stage due to wide-spread metastasis within six months to one year, while others may survive longer. This study was aimed to evaluate the risk factors for breast carcinoma occurrence and histopathological features of breast carcinoma developed in the social and economical conditions of Pakistan. A total of 224 female breast cancer diagnosed patients with uncovered medical insurance visiting at the Oncology clinic of a teaching hospital at Karachi, Pakistan were selected for the study. Two hundred and twenty-four [224] healthy female subjects free of any cancer diagnosis were selected as control from different areas of the city. Information on stress, occupation, life history, and life style was obtained through personal interviews. Breast tumour pathology was evaluated for histological grade, lymph node metastasis and hormone receptor status by using standard methods. Student's t-test, Chi-square test and ANOVA were used for comparison. Breast cancer patients in significantly high percentage reported early marriages, abortion occurrence, stressful life style, family cancer history and past disease suffering from diabetes and hypertension. Life style including aerosol chewing and fat rich food intake was significantly high among the patients [p<0.05]. On histopathological analysis, patients at the age of 40 years and below were identified in significantly high percentage with tumour grade III, 1-3 lymph node metastasis and hormone receptor negative type. Increasing age was associated with low tumour grade and less percentage of lymph node metastasis. Significantly high percentage of patients were presented with hormone receptor positive tumour [p<0.05]. The contributing factors for breast carcinoma occurrence were related to life history and life-style of the patients. Medical insurance uncovered patients at initial diagnosis were presented in significantly high percentage with advanced disease including high tumour grade and lymph node metastasis due to less use of preventive and screening service which delays the diagnosis, effecting both survival and treatment cost

Morphological and immunofluorescent patterns of subepidermal autoimmune bullous diseases of skin in Karachi Pakistan

Subepidermal autoimmune blistering disorders [SEABD] are common in dermatological practice. Direct immunoflourescence [DIF] staining is considered gold standard for the diagnosis of these disorders. The study was conducted to determine the morphological and DIF patterns of these disorders. Retrospective Study. This study was conducted at the department of Pathology, Basic Medical sciences Institute, Jinnah Postgraduate Medical centre, Karachi, from January 2002 to July 2007. Morphological and DIF patterns were recorded and categorical diagnoses of these disorders were established. Bullous permphigoid [BP] was found to the most frequent disorder with a relative frequency of 60.71% and mean age of 54.82 years. Relative frequencies of childhood bullous pemphigoid [Ch BP], dermatitis herpetiformis [DH], chronic bullous dermatosis of childhood [CBDC] and herpes gestationis [HG] were 10.71%, 14.28%, 10.71% and 3.57% respectively. Direct immunofluorescent staining is one step procedure that should be done in all cases of SEABD. Use of salt split technique and immune electron microscopy would further enhance the level of certainty in SEABD

Effect of combined oral contraceptive pills on body mass index [BMI] in women attending family planning centres, Karachi, Pakistan

To see the effect of combined oral contraceptive pills on Body Mass Index [BMI] of women. A descriptive study. The study was conducted at Family Planning Centers at social obstetrical unit Baqai Medical University and Reproductive and Health Sciences [RHS] Institute, a family planning unit, at Jinnah Post Graduate Medical Center Karachi, from November 2010 to April 2011. This study was carried out on 50 patients of reproductive age 20-40 years. Patients with Cardiac, Renal and Liver syfunction were excluded. Diabetic women taking sedative and hypnotics, anti-tubercular treatment were also excluded. All routine investigations were performed. BMI was done on initial visit re-evaluated after one, three and six months and data was analyzed. Fifty women were selected. They were divided into four categories, Control [category 0] i.e. before the start of COCPs, after 1 month [category 1], 3 months [category 2] and 6 months [category 3]. On initial visit mean BMI of control is found to be 22.53 +/- 1.92. Category 1 showed mean BMI of 22.53 +/- 1.92 kg/m2 while BMI of category 2 is 22.53 +/- 1.92 kg/m2 category 3 is 22.91 +/- 1.87. After completion of study mean increase in BMI of category 3 was 0.38 kg/m[2]. Mean increase in BMI of category 3 is negligible

Evaluation of protective role of benzodiazepine in noise stress induced activation of hypothalamo-pituitary adrenal axis in albino rats

Noise, whether pleasant or not, is ever present in nature. Not much work can be done without noise, in the industries, fish market, social gatherings; it is constantly in the background. Thought it seems harmless loud and or prolonged exposure to noise can cause health problems to the populace. Noise, as a recognized stressogenic factor, has been postulated to stimulate the HPA axis leading to the release of stress hormones. The present study was designed to assess the changes occurring in the level of stress hormones [ACTH and Corticosterone] in albino rats when acutely [24 hrs] exposed to loud noise with subsequent ameliorating effects of benzodiazepine [Valium/ Diazepam] which will given to the rats to alleviate the symptoms of stress. Prospective Experimental Study. This study was conducted in the Department of Anatomy, JPMC, Karachi from Jan 2006 to June 2008. Three groups of 10 rats labeled A, B and C serving as control [no noise], noise stress [24hrs] and noise stress [24hrs] with diazepam [5mg/kg] respectively. The groups B and C were exposed to white noise at 100 dB. At the end of study the animals were sacrificed and their mean plasma concentration of ACTH and corticosterone were measured. A highly significant increase in mean plasma concentration of ACTH [150.90 +/- 14.71 pg/ml] and corticosterone [5.72 +/- 5.75 pg/ml] and corticosterone [1.75 +/- 0.25 micro/dl] concentration of control animals. This increase was significantly ameliorated by pre treatment of diazepam. Our study shows the protective role of diazepam in stress induced by noise