Prevalence of cutaneous leishmaniasis in the largest populated city Karachi, Pakistan / Prevalência de leishmaniose cutânea na maior cidade populosa de Karachi, Paquistão

The study was undertaken from September 2018 to April 2019 to determine the prevalence of cutaneous leishmaniasis in human beings living in six districts of Karachi. Suspected persons were screened for the disease and positive cases were identified on the basis of skin lesions and blood samples. Samples were observed by mounting their smear. A total of 207 subjects of different ages and sex groups were investigated, however, only 192 (92%) of the suspected cases were found to have the disease 64% of cases were male which were significantly high (p<0.05), than female 36%. The lesion was more frequently detected among the youth ages of 21-30 years (31%) as compared to other groups. In both sexes, legs were found to be more infected (25% male + 20% female) followed by arms (20% male + 0% female) and face (15% male +11% female). The mixed body parts had shown the lowest infections such as (4% in males + 5%) in females. In conclusion, the highest and lowest leishmaniasis infections were observed in District West (23% male + 9% female) followed by District East (15% male + 7% female), District Malir (11% male+ 4% female), District Central (7% male + 5% female), District Korangi (4% male + 7% female) and District South (4% male + 4% female) respectively.

O estudo foi realizado de setembro de 2018 a abril de 2019 para determinar a prevalência de leishmaniose tegumentar em seres humanos que vivem em seis distritos de Karachi. Pessoas suspeitas foram rastreadas para a doença e os casos positivos foram identificados com base em lesões de pele e amostras de sangue. As amostras foram observadas montando seu esfregaço. Um total de 207 indivíduos de diferentes idades e grupos sexuais foi investigado, no entanto apenas 192 (92%) dos casos suspeitos foram encontrados para ter a doença; 64% dos casos eram do sexo masculino, que foram significativamente elevados (p < 0,05), e do sexo feminino 36%. A lesão foi detectada com maior frequência entre os jovens de 21 a 30 anos (31%) em comparação com os outros grupos. Em ambos os sexos, as pernas estavam mais infectadas (25% homens + 20% mulheres), seguidas pelos braços (20% homens + 0% mulheres) e rosto (15% homens + 11% mulheres). As partes mistas do corpo mostraram as infecções mais baixas (4% homens + 5% mulheres). Em conclusão, as infecções de leishmaniose mais altas e mais baixas foram observadas no Distrito Oeste (23% homens + 9% mulheres) seguido pelo Distrito Leste (15% homens + 7% mulheres), Distrito Malir (11% homens + 4% mulheres), Distrito Central (7% homens + 5% mulheres), Distrito Korangi (4% homens + 7% mulheres) e Distrito Sul (4% homens + 4% mulheres), respectivamente.

Prevalence of cutaneous leishmaniasis in the largest populated city Karachi, Pakistan

Abstract. The study was undertaken from September 2018 to April 2019 to determine the prevalence of cutaneous leishmaniasis in human beings living in six districts of Karachi. Suspected persons were screened for the disease and positive cases were identified on the basis of skin lesions and blood samples. Samples were observed by mounting their smear. A total of 207 subjects of different ages and sex groups were investigated, however, only 192 (92%) of the suspected cases were found to have the disease 64% of cases were male which were significantly high (p 0.05), than female 36%. The lesion was more frequently detected among the youth ages of 21-30 years (31%) as compared to other groups. In both sexes, legs were found to be more infected (25% male + 20% female) followed by arms (20% male + 0% female) and face (15% male +11% female). The mixed body parts had shown the lowest infections such as (4% in males + 5%) in females. In conclusion, the highest and lowest leishmaniasis infections were observed in District West (23% male + 9% female) followed by District East (15% male + 7% female), District Malir (11% male+ 4% female), District Central (7% male + 5% female), District Korangi (4% male + 7% female) and District South (4% male + 4% female) respectively.

Resumo O estudo foi realizado de setembro de 2018 a abril de 2019 para determinar a prevalência de leishmaniose tegumentar em seres humanos que vivem em seis distritos de Karachi. Pessoas suspeitas foram rastreadas para a doença e os casos positivos foram identificados com base em lesões de pele e amostras de sangue. As amostras foram observadas montando seu esfregaço. Um total de 207 indivíduos de diferentes idades e grupos sexuais foi investigado, no entanto apenas 192 (92%) dos casos suspeitos foram encontrados para ter a doença; 64% dos casos eram do sexo masculino, que foram significativamente elevados (p 0,05), e do sexo feminino 36%. A lesão foi detectada com maior frequência entre os jovens de 21 a 30 anos (31%) em comparação com os outros grupos. Em ambos os sexos, as pernas estavam mais infectadas (25% homens + 20% mulheres), seguidas pelos braços (20% homens + 0% mulheres) e rosto (15% homens + 11% mulheres). As partes mistas do corpo mostraram as infecções mais baixas (4% homens + 5% mulheres). Em conclusão, as infecções de leishmaniose mais altas e mais baixas foram observadas no Distrito Oeste (23% homens + 9% mulheres) seguido pelo Distrito Leste (15% homens + 7% mulheres), Distrito Malir (11% homens + 4% mulheres), Distrito Central (7% homens + 5% mulheres), Distrito Korangi (4% homens + 7% mulheres) e Distrito Sul (4% homens + 4% mulheres), respectivamente.

Ocular surface squamous neoplasia masquerading as superior limbic keratoconjunctivitis

To report a case of ocular surface squamous neoplasia [OSSN] masquerading as superior limbic keratoconjunctivitis [SLK]. A 62-year-old woman was referred with foreign body sensation, irritation, photophobia and decreased vision in the left eye. She was initially treated for 10 months with intermittent topical corticosteroids for a presumed diagnosis of SLK. She underwent excisional biopsy of the superior conjunctiva and was found, on histopathologic evaluation, to have OSSN with moderate to marked dysplasia. This is the first reported case of OSSN masquerading with signs and symptoms of SLK. Any ocular surface lesion refractory to standard medical treatment should raise suspicion for a malignant process and warrant further cytologic or histopathologic evaluation

Transurethral microwave therapy [TUMT] for benign prostatic hyperplasia ; our experience

Minimally invasive office -based treatment for benign prostatic hyperplasia [BPH] are challenging the traditional surgical and medical management options for symptomatic BPH. The aim of this study is to assess the efficacy of transurethral microwave therapy [TUMT] on spontaneous voiding, maximum flow rate and residual urine volume in patients with otherwise poor general health and BPH. Thirty [30] patients with associated comorbid diseases and retention of urine [acute and chronic] due to BPH were subjected for TUMT as an outpatient procedure, from January 2002 to November 2003. Follow up was performed 10 days post TUMT, and then monthly until 3 months clinically and by assessing, spontaneous voiding, maximal flow rate and residual urine volume. Out of 30 treated patients, 5 were able to void spontaneously [without catheter] at the end of 12 weeks following TUMT. There was a little improvement of maximum urinary flow rate and residual urine volume at the end of the same period. TUMT is an alternative choice for the treatment of patients with BPH and chronic medical illnesses or those refusing surgery. However low energy protocol TUMT is not an effective treatment mode for patients with urinary retention due to BPH

What is central toxic keratopathy syndrome if it is not diffuse lamellar keratitis grade IV?

The Central Toxic Keratopathy [CTK] syndrome describes a rare, acute, self-limited, non-inflammatory process that yields central corneal opacification and significant hyperopic shift after refractive surgery. Despite being exceedingly rare, certain clinical features of CTK give the condition a striking resemblance to other more serious inflammatory conditions, including diffuse lamellar keratitis [DLK]. As the authors demonstrate in this article, despite the overlapping clinical features, CTK is a disease process that is distinct from DLK and, therefore, in need of distinct management interventions

Postoperative urological complications of renal transplantation; Al Karama hospital experience

Studying early post kidney transplant urological complication will provide a feed back evaluation for the surgical technique used and the way of complication management. To study the postoperative urological complications and their management in the first 6 months following renal transplantation. This is a retrospective study in which 123 patients with end stage renal disease [ESRD] underwent renal transplantation from January 2001 to October 2004 in Al Karama teaching hospital, Baghdad -Iraq. All the transplanted kidneys were from living donors. Direct matching between the serum of recipient and lymphocytes of the donor was negative. Extravesical ureteroneosystostomy was carried out using a stent across the anastomotic site. Postoperatively recipients were followed for 6 months by clinical and regular laboratory tests. Ultrasound and color Doppler examinations were performed when there was any evidence of decreased urinary output, allograft dysfunction, or clinical suspicion of rejection. In 123 patients aged 5-59 years with a mean age of 34 years, renal transplantation was carried out. Postoperative urological complications within the first 6 months were reported in 12 [9.75%] patients including urinary leakage in 6 [4.8%], ureteral obstruction in 3 [2.4%], and lymphocele in 3 [2.4%] patients. Major urological complications after renal transplantation contribute to patient morbidity and compromise graft function. Early diagnosis and treatment will avoid loss of the graft

Ileal-conduit following cystectomy, single-institution revision of indications and outcome

To revise indications, case fatality ratio, and postoperative early and late complications of ileal conduit as a method of urinary diversion. This is a retrospective study in which 200 patients underwent an ileal conduit from August 1994 to December 2000 in Mansoura Urology and Nephrology Center, Mansoura, Egypt. Preoperative criteria of patient selection, peroperative findings, and postoperative follow-up data were reviewed. In 200 patients aged 29-75 years, with a mean age of 55.84 +/- 8.91 years, the ileal conduit was chosen as a method of urinary diversion, due to one of the following patient or surgical factors; 50 [25%] cardiopulmonary co-morbidities, 27 [13.5%] liver cirrhosis, 20 [10%] impaired renal function, 18 [9%] poorly controlled diabetes mellitus, and 3 [1.5%] morbid obesity. Frozen section pathological examination showed carcinoma invasion of the urethra in 26 [13%], and prostate stroma in 16 [8%] male patients. Severe adhesions and difficult cystectomy were encountered in 25 [12.5%] patients. Tumor was found at or close to the bladder neck in 13 [6.5%] female patients, and 2 [1%] patients were found to have short mesentery. The mean follow up period was 90.02 +/- 22.63 months. Fatality rate was 2%. Twenty-three [11.5%] patients had early complications, while 36 [23.7%] patients had late complications. Ileal conduit is still the best urinary diversion method in many patients who have bladder cancer with associated chronic medical disease or certain surgical factors that render other urinary diversion methods more difficult, carry more postoperative morbidity and mortality, or both

Crohn's disease in Saudi Arabia: a clinicopathological study of 12 cases

In this report we present our experience with 12 cases of Crohn's disease out of 1279 consecutive colorectal biopsies [0.9%], seen during an 11 years period [1983-1994] in a tertiary care teaching hospital. During the period 76 cases [6%] of Ulcerative Colitis [UC] were seen. Of the 12 patients with Crohn's disease, seven were males and five were females, all Saudi nationals aged 16-39 with a median of 23 year, relatively younger than those with UC seen during the same period. Recurrent colicky abdominal pain was the striking presenting symptoms in all patients, commonly associated with weight loss. The disease involved both small and large bowel in eight patients [67%] and the colon alone in one patient. Granulomas were seen in seven patients [58%]. Surgery was offered for two patients and most of the remaining patients were symptomatic on follow up