Secondary ameloblastic carcinoma of mandible with pulmonary metastasis

Ameloblastic carcinoma [AC] is a very rare odontogenic malignancy. Primary AC is more common in maxilla, while secondary AC is more common in mandible. Histologically, it is an ameloblastoma with features of cancer. Presence of metastasis is not necessary to establish the diagnosis. This tumor usually metastasises in bone or lungs. We report a case of aggressive secondary AC of mandible with lung metastasis. There are few cases in medical literature discussing management of AC with lung metastasis. In this case, a 42-year woman, who was diagnosed with ameloblastoma of right mandible, was treated with right hemi-mandibulectomy. However, 10 years later, the patient developed AC with pulmonary metastasis. Patient received six cycles of carboplatin-paclitaxel-based regimen. There was noted a partial response to the therapy. However, the patient went into respiratory failure, although she was provided adequate analgesic control as part of end-of-life care. Further, oncological or surgical management was not possible as patient had poor performance status

Antioxidant, antibacterial and antiproliferative activities of pumpkin (cucurbit) peel and puree extracts - an in vitro study

Natural resources right from the beginning of the human civilization has paved the way to human being to combat different challenges. The big challenge was to safe the human being from diseases and shortage of food. Plants helped the man in both areas very efficiently. No doubt when plants are used as food actually we are also taking lot of compounds of medicinal values in an excellent combination which naturally reduce the risk of diseases. Extraction and purification of several medicinally important compounds also gave the way to develop pharmaceutical industry in addition to its own therapeutic effects against different lethal diseases. Pumpkin is one of the several medicinal important vegetables used in different way on the behalf of its admirable power to combat different diseases. Antioxidant and biological studies showed very important results. A good coherence was found among extraction yield [10.52 to 18.45%], total phenolics [1.13 to 6.78 mg GAE/l00g], total flavonoids [0.23 to 0.72mg CE/l00g] and antioxidant potential [-70%]. Antibacterial assays of peel and puree extracts advocated good potential to stop the growth and division of pathogenic bacteria. Further biological activity study was carried out using MDBK cancer cell line. The growth inhibitory effect on cancer cell line using MTT assay showed methanol extracts of peel and puree both remained efficient to inhibit growth [-35%] and cell division of cancer cells. Our results showed that extracts of pumpkin puree and its waste, peel, may be utilize to prepare functional food against pathogenic born diseases and most active compounds may also be extracted, concentrated and converted into tablets or suspension form for therapeutic purposes

Effects of natural environmental conditions on the ovarian histometric dynamics of five striped squirrels (Funambulus pennanti) / Efectos de las condiciones ambientales naturales sobre la dinámica histométrica de ovarios en la ardilla de las palmeras (Funambulus pennanti)

The present study was designed to determine the morphological and histological variations in the female palm squirrel's reproductive organs which inhabit croplands of central Punjab. 16 specimens were collected from 3 different locations of Faisalabad district during different months in order to collect their ovaries samples in order to determine the breeding phenology of this species. Body weight and external body measurements were recorded. Two adult females were autopsied each month and their ovaries were extracted. Tissue were prepared by the tissue paraffin technique and stained by H&E. Seasonal variations in the follicular size and shape were observed. Statistical analysis revealed that values of all parameters of ovaries were significantly (P<0.01) higher during peak folliculogenic phase (January to May) as compared to low folliculogenic phase (November­December). Three reproductive phases were observed according to follicular development i.e., quiescent period (November- December), recrudescence period (January) and peak reproductive phase (February­March). In conclusion of this study, different phases of sexual activities are determined which are controlled by seasonal variations. These variations are in accordance to different physical factors which influences gross anatomical and histological changes of ovaries and folliculogensis of female five-striped northern palm squirrel (Funambulus pennanti) for adjustments in breeding phenology.

El presente estudio fue diseñado para determinar las variaciones morfológicas e histológicas en los órganos reproductores de la ardilla de las palmeras que habita en las tierras de cultivo del centro de Punjab. Dieciséis muestras fueron recolectadas en 3 lugares diferentes del distrito de Faisalabad durante diferentes meses con el fin de obtener los ovarios y determinar la fenología reproductiva de esta especie. Se registraron el peso corporal y las medidas corporales externas. Se realizaron autopsias de dos hembras adultas cada mes y sus ovarios fueron extraídos. Se prepararon los tejidos por técnica de parafina y tinción H & E y se observaron las variaciones estacionales en el tamaño y forma folicular. El análisis estadístico reveló que los valores de todos los parámetros de los ovarios fueron significativamente más altos durante la fase foliculogénica (enero a mayo), en comparación con la fase baja (noviembre-diciembre) (P <0,01). De acuerdo al desarrollo folicular se observaron tres fases reproductivas, el período de reposo (noviembre-diciembre), el período de recrudecimiento (enero) y la fase peak reproductiva (febrero-marzo). En conclusión las diferentes fases de las actividades sexuales definitivamente están controladas por variaciones estacionales. Estas variaciones se ajustan a diferentes factores físicos que influyen en los cambios anatómicos e histológicos de los ovarios y la folículogénesis de la ardilla hembra de las palmeras (Funambulus pennanti) para realizar ajustes en la fenología de su reproducción.

Comparison of post-operative pain with topical glyceryl trinitrate cream versus lateral internal anal sphincterotomy after hemorrhoidectomy

Background: hemorrhoidectomy is the surgical treatment for grade III, IV hemorrhoids. Hemorrhoidectomy is notorious for postoperative pain which may be due to spasm of the internal anal sphincter

Objective: to compare mean post-operative pain with 0.2% topical Glyceryl Trinitrate cream versus lateral internal anal sphincterotomy after hemorrhoidectomy

Methodology: Setting: general Surgery ward, Sheikh Zayed Medical College/ Hospital Rahim Yar Khan. Duration: from 4[th] February to 4[th] August, 2015

Design: randomized Controlled Trials. A total of 60 patients with hemorrhoids were included in this study. Thirty patients were in group A and subjected to Milligan-Morgan open hemorrhoidectomy followed by post-operative application of 0.2% topical Glyceryl Trinitrate [GTN] using a measuring spoon, three times a day. 30 patients were included in group B and treated with Milligan-Morgan open hemorrhoidectomy along with lateral internal sphincterotomy. All the patients were followed up to one week for post-operative pain assessment and mean post-operative pain was noted for both groups at 7th day postoperatively. This all data was recorded on an especially designed Proforma. The data was entered in SPSS version 16 and analyzed

Results: mean post-operative pain score was significantly low in group B [2.07 +/- 0.9] as compared to group A [3.17 +/- 1.1] [p=0.0005]. Conclusion: Internal sphincterotomy with open hemorrhoidectomy is an effective method to reduce posthemorrhoidectomy pain as compared to 0.2% topical Glyceryl Trinitrate [GTN] cream

Diagnostic accuracy of surgeon-performed focused assessment sonography in trauma patients with blunt abdominal injury

Background: computerized tomography [CT] Scan is the gold standard for imaging in blunt abdominal trauma. Focused Assessment Sonography in Trauma [FAST] is a quickly performed screening technique aimed to detect collections of free fluid

Objective: to determine the diagnostic accuracy of surgeon-performed Focused Assessment Sonography in patients with blunt abdominal Trauma by taking operative findings as gold standard in detecting hemoperitoneum

Methodology: this cross sectional study was conducted in Department of Emergency and Trauma, Sheikh Zayed Hospital, Rahim Yar Khan from 1[st] January to 30[th] June 2015. A total of 167 patients with blunt abdominal trauma within 24 hours were included in this study. Surgeon performed Focused Assessment Sonography in Trauma[FAST] was done in all patients with Ultrasound Machine for detection of hemoperitoneum. All the patients were undergone through exploratory laparotomy and compared the findings of FAST. All this information was entered on Proforma. Data was entered and analyzed using SPSS version 16

Results: the sensitivity, specificity, positive and Negative predictive value as well as accuracy of surgeon performed FAST in detecting hemoperitoneum were 83.8%, 92%, 90.5%, 86% and 88% respectively

Conclusion: FAST has a high accuracy. It can be included in the initial evaluation of adult patients with Blunt abdominal trauma [BAT] and it will assist in rapidly identifying the need for laparotomy

Relationship between serine/threonine kinase 39 gene polymorphisms with some cardiac biomarkers in hypertensive patients

Aim: This study aimed to evaluate the association between STK39 SNP rs35929607 and some cardiovascular risk factors in hypertension patients in holy Kerbala city, Iraq

Materials and Methods: We included 74 hypertensive patients with no signs and symptoms of renal impairment and another 30 control subjects. The links between genotype and hypertension were examined. Then, the SNP related variances in the blood pressure and remaining cardiovascular risk factors were studied

Results: There is no significant association between STK39 rs35929607 and hypertension in current study. However Allele A showed a significant association in hypertensive patient compared with control group particularly in female gender. The hypertensive patients showed a significant higher result in age, BMI, FBS, total cholesterol, and STG, LDL-C and lower level in HDL-C

Conclusion: The association between the SNP rs35929607ofSTK3 and hypertension was not significant in current study in Kerbala population of Iraq. Furthermore, only Allele A showed a significant association with hypertension in females group. Further studies needed to clarify the effect of other STK39 variants on these cardiovascular risk factors

Malaria in Karachi and other areas in Sindh

Malaria is one of he common febrile conditions which is often diagnosed on the basis of clinical signs and symptoms. The objective of the study was to determine the prevalence of malaria in Karachi. In this study 463 GP's were interviewed at Karachi. Out of 50 to 70 patients seen by each on a daily basis, 10 - 15% cases were diagnosed as Malaria. In a follow up study in Karachi and two other areas in Sindh, Plasmodium vivax was found to be two times higher than Plasmodium falciparum. Mosquito density in respect of the anopheles corresponds with higher number of cases during July - September

Small bowel volvulus leading to gangrene and short bowel syndrome

A young man was operated for acute abdomen. Laparotomy revealed small bowel diverticulosis with very short mesentery leading to volvulus of near total small bowel. Resection and end to end anastomosis was performed. Patient ended up with short bowel syndrome

Short bowel syndrome: an update review article

With the advent of anesthesia and better operative facilities, many patients suffering from dangerous gut diseases that were not likely to survive in near past are saved now. Non availability of parenteral nutrition was another factor in their early mortality. The advent of parenteral nutrition and its better availability has prolonged the misery of this killer disease. On the other hand development of rh-GH, IGF-I, short bowel lengthening, short bowel transplantation and better immunosuppressants have a ray of hope for the better survival of these patients. Some of the patients are saved and enjoying independent life, a lot are handicap of parenteral nutrition while majority is prey to this killer disease. Yet it is challenging era for the whole universe of medicine

Surgical complications of abortions at periphery

Objectives: To study the patients presented with catastrophic abdominal misadventure due to abortion performed by untrained birth attendants to get rid of unwanted fetus by un-indicated procedures in unfavorable circumstances

Design: Observational case series

Place and Duration of Study: Surgical Unit I, Sh. Zayed Hospital, Rahim Yar Khan from July, 2001 to August, 2004

Patients and Methods: Forty patients from different age groups presented with this killer problem. Majority was concealing it. They were resuscitated, operated and managed postoperatively

Results: These patients presented late, suffered financial loss, morbidity and significant mortality

Conclusion: Unplanned abortions are catastrophic. Education of masses in regard to birth control is mandatory

Cutaneous metastasis in gastric cancer

This is a case report of newly born twins. The live twins were with two separate heads and a symmetrical body, conjoined in a sagittal plane. Their thorax and abdomen were broader then singleton normal. Spines were separate in cervical regions but gradually approached each other and completely fused at sacrum. Single perineum had an imperforate anus

Anti-HIV seroprevalence in tuberculous patients

Seroprevalence of anti-HIV in tuberculous patients was carried out in collaboration with the AIDS surveillance Centre in Microbiology Division of IPH Lahore and Provincial AIDS control programme, D. G. Office Lahore. The sample consisted of 1348 patients admitted in Ghulab Devi Hospital during the period of July-August '2002. Out of these 774 [57.4%] were male patients and 574 [42.6%] were female patients. Two male patients [0.10%] were found to be positive for antiHIV, which definitely points towards future problem if left uncontrolled