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Objectives:To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan.Methods:Tissue smears and aspirates from 448 cutaneous leishmaniasis (CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1 (ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species.Results:An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica (L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major (L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis.Conclusions:In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents (Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.
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Objectives: To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan. Methods: Tissue smears and aspirates from 448 cutaneous leishmaniasis (CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1 (ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species. Results: An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica (L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major (L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis. Conclusions: In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents (Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.
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OBJECTIVE@#To report presence of Leishmania major in Khyber Pakhtunkhwa of Pakistan, where cutaneous leishmaniasis (CL) is endemic and was thought to be caused by Leishmania tropica only.@*METHODS@#Biopsy samples from 432 CL suspected patients were collected from 3 southern districts of Khyber Pakhtunkhwa during years 2011-2016. Microscopy on Giemsa stained slides were done followed by amplification of the ribosomal internal transcribed spacer 1 gene.@*RESULTS@#Leishmania amastigotes were detected by microscopy in 308 of 432 samples (71.3%) while 374 out of 432 samples (86.6%) were positive by ribosomal internal transcribed spacer 1 PCR. Subsequent restriction fragment length polymorphism confirmed L. tropica in 351 and L. major in 6 biopsy samples.@*CONCLUSIONS@#This study is the first molecular characterization of Leishmania species in southern Khyber Pakhtunkhwa. It confirmed the previous assumptions that anthroponotic CL is the major CL form present in Khyber Pakhtunkhwa province. Furthermore, this is the first report of L. major from a classical anthroponotic CL endemic focus identified in rural areas of Kohat district in southern Khyber Pakhtunkhwa.
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Objective To report presence of Leishmania major in Khyber Pakhtunkhwa of Pakistan, where cutaneous leishmaniasis (CL) is endemic and was thought to be caused by Leishmania tropica only. Methods Biopsy samples from 432 CL suspected patients were collected from 3 southern districts of Khyber Pakhtunkhwa during years 2011–2016. Microscopy on Giemsa stained slides were done followed by amplification of the ribosomal internal transcribed spacer 1 gene. Results Leishmania amastigotes were detected by microscopy in 308 of 432 samples (71.3%) while 374 out of 432 samples (86.6%) were positive by ribosomal internal transcribed spacer 1 PCR. Subsequent restriction fragment length polymorphism confirmed L. tropica in 351 and L. major in 6 biopsy samples. Conclusions This study is the first molecular characterization of Leishmania species in southern Khyber Pakhtunkhwa. It confirmed the previous assumptions that anthroponotic CL is the major CL form present in Khyber Pakhtunkhwa province. Furthermore, this is the first report of L. major from a classical anthroponotic CL endemic focus identified in rural areas of Kohat district in southern Khyber Pakhtunkhwa.
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Objective: The objective of this study was to evaluate the construction faults associated with complete dentures made by clinical students
Study Design: Descriptive / cross-sectional study
Place and Duration of Study: This study was conducted at Prosthodontics; Department Institute of Dentistry; Liaquat University of Medical and Health Sciences Jamshoro from May 2015 to October 2015
Materials and Methods: Total 197 complete denture wearer's patients were recruited in this study. Faults associated with vertical dimension, centric relation, denture base thickness, finishing and polishing were examined and noted in proforma. Data was analyzed by SPSS version 17.0
Results: Out of 197 patients male and female patients were 56.3% and 43.7% respectively. Vertical dimension was found to be high in 82% patients and centric relation was noted 81% as right and 19% as wrong. According to thickness of denture base plate, 80% were thick and 5% were thin denture base. According to finishing and polishing of dentures, 55% dentures were seen with satisfactory results
Conclusion: It is concluded that the most common faults in construction of complete dentures were high vertical dimension, thick denture base plates and finishing and polishing
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This study was to determine the orthodontic treatment need in local population visiting the Liaquat University of Medical and Health Sciences Hospital by using index of orthodontic treatment need. Descriptive cross sectional study. This study was conducted on patients visiting to Dental outpatient department [OPD] of Liaquat University of Medical and Health Sciences Hospital, Jamshoro from September 2012 to October 2013. Informed written consent was taken from 150 patients' satisfying the inclusion criteria,history and clinical examination was done on patients by using index of orthodontic treatment need. SPSS version 19 was used to analyze the data and frequency was determined for categorical variables. Mean and standard deviation was computed for numerical variables. According to Dental Health Component [DHC] treatment need 36.7%, 34.7%, 24.7% and 4.0% found to have orthodontic treatment need from no little treatment to very great treatment respectively and according to Aesthetic Component [AC] treatment need 49.3%, 44.0% and 6.7% found to have orthodontic treatment need from no little treatment to great treatment need. It was concluded that the patients of this locality found to have increased need for orthodontic treatment
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Adult , Female , Humans , Male , Dental Service, Hospital , Cross-Sectional Studies , PopulationABSTRACT
To determine the various lipid profile pattern of dyslipidimia in patients of chronic renal failure. Cross-sectional study. This study was conducted at Nephrology department of Isra University hospital Hyderabad and Medicine Department Civil hospital Nawabshah, from October 2013 to September 2014. This study consisted of 237 patients of chronic renal failure asses on detailed history regarding chronic renal failure, patients were subject to relevant investigations i.e. fasting lipid profile and venous blood was drawn after 14 hours fasting state in the early morning and sent to laboratory for analysis of fasting lipid profile. Inclusion Criteria were all patients of chronic renal failure with 1 years history, age > 35 to 60 years and either any sex. Diagnosed on the basis of serum creatinine as define in operational definition. Exclusion Criteria were patients on lipid lowering agents, acute complication of diabetes mellitus such as diabetic keto-acidosis, patients suffering from hypothyroidism, type 1 DM and HTN, lactic-acidosis, hypoglycemia. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. Out of 237 patients, 113[47.68%] patients were 51 to 60 years of age, 94 [39.66%] were 41 to 50 years of age and 30[12.66%] were 35 to 40 years as presented in Chart No 1. The average age of the patients was 50.11 +/- 6.94 years. There were 54.43% [129/237] male and 45.57% [108/237] female. Various lipid profile pattern of dyslipidimia in patients of chronic renal failure are presented in table-l. Results of fasting lipid profile are Triglycerides high in 86[36.3%], HDL low in 76[32.1%] cases, LDL in high 83[35%] cases, Cholesterol high in 105[44.3%] cases and VLDL-cholesterol high in 68[28.7%]. Stratification analysis showed that lipid profile pattern of dyslipidemia was insignificant between male and female as presented in table 2. While with respect to age groups, rate of Cholesterol, triglycerides, LDL-cholesterol was high in above 40 years of age groups as compare to 30 to 40 years of age groups. Rate of low HDL was also high in above 40 years of age groups as compare to 30 to 40 years as presented in table 3. In conclusion, our study demonstrated that dyslipidemia often our patients chronic renal failure. This underscores the need for the first test patients with lipid abnormalities early treatment can prevent cardiovascular events delay chronic kidney disease
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Humans , Male , Middle Aged , Female , Adult , Lipids/blood , Cross-Sectional Studies , Kidney Failure, ChronicABSTRACT
Carcinomatous Meningitis [CM] is a relatively uncommon metastatic complication of systemic solid tumors. The condition is mostly diagnosed by presence of malignant cells in the cerebrospinal fluid. The prognosis of the condition is generally poor. CM very rarely complicates pancreatic cancers and very few cases have been reported in the literature. We present a case of a 58-year old female patient operated for pancreatic head carcinoma. She made an immediate uneventful recovery after her pancreatico-duodenectomy. She presented 3 weeks post-surgery with acute confusional state and was diagnosed as a case of CM
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Objective: to evaluate the outcome of subacromial steroid injection in subacromial impingement syndrome in our racial group population
Material and Methods: 150 cases having clinical diagnosis of SIS of age >16 years were included from outpatient department of Orthopedic Surgery, Services Hospital Lahore during 12- 03-09 to 14-12-09. Patient having constant gradeA[less than 70 constant score] and grade B [70- 79 constant score] were included while those having full thickness tears of rotator cuff, internal rotation contracture, previous open shoulder surgery or gleno-humeral instability were excluded from study. Methyl Prednisolone Acetate 40 mgs along with 5 ml of 0.5 % Bupivacaine injection were given administered in subacromial space to all patients under aseptic conditions. Patients were follow-up at one week; three weeks, and six weeks and outcome was assessed by Constant scoring system. Improvement was labeled by the achievement of grade C [80-89], D [90-100] on constant score
Results: the mean age was 50 years+/- 2.50 [range 35-65], 38.7% were of 30-40 years, and 38.7% were 40-50 years and 22. 7 % were >50 years of age. 134 [89.3%] were male patients and male to female ratio was 9:1. Right shoulder involvement was 76.7% and left sided was 22.7%. Outcome at first week was grade A in 14.0%, grade Bin 84.7% and grade C in 1.3%. Outcome at third week was grade B in 10.0%, grade C in 88% and grade D in 2.0% and there was no patient in grade A. Outcome at end of six week was grade A in 1.3%, grade B in 13.3% and grade C in 53.3% and grade Din 31.3%. Final outcome was 85.3% improvement [CSS grade C and D] and 14.7% nonimprovement [CSS grade A and B]
Conclusion: subacromial steroid injection shows early decrease in morbidity of the patient. It has low complication rate and is cost effective
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Objective: To evaluate the new cases and clinical types of leprosy in interior Sindh
Methods: Data analysis and evaluation of 3-year record of leprosy centers/clinics in Interior Sindh
Results: Of total 238 new registered cases, 98 [41%] were diagnosed after a delay of 1 year. The types of disease found were tuberculoid 59 [25%], borderline tuberculoid 100 [42%], borderline 13 [5%], borderline lepromatous 53 [22%] and lepromatous lepromatous 13 [5%] cases. Multibacillary cases were 179 [75%] and paucibacillary 59 [25%]
Conclusion: The 3-year analysis of Interior Sindh shows endemic regions of leprosy in Pakistan which will help in devising strategy for an effective leprosy control program
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Humans , Male , Female , Leprosy, Tuberculoid , Leprosy, Paucibacillary , Leprosy, Borderline , Leprosy, Multibacillary , Leprosy, LepromatousABSTRACT
The rate of recurrence in high grade non muscle invasive bladder cancer [NMIBC] is 70% with progression rate of 15-40% at 5 years. The treatment of high grade NMIBC is intravesical BCG therapy, however for high risk cases radical cystectomy is recommended. In this study we determined the response of high grade NMIBC to BCG therapy and the factors affecting it in south Asian population. This retrospective cohort study was conducted on 64 patients treated with intravesical BCG for high grade NMIBC from Dec 2008 to July 2012. Smoking, tumor size, location and multiplicity were taken as prognostic factors. Recurrence and progression were determined by cystoscopy and upper tract imaging according to European Association of Urology guidelines. The association of prognostic factors with recurrence and progression was determined. The rate of recurrence and progression was found to 45.8% and 27.1% respectively after a mean follow up 28.36 months. Smokers had 4 times greater odds of progression of tumor as compared to non-smokers. Patients with large tumors had 6.7 times greater odds of progression as compared to patients with small tumors. Smokers with large and multiple high grade NMIBC constitute the high risk group. These patients may be offered early radical cystectomy and advised to stop smoking
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To determine the diagnostic accuracy of high-resolution MR imaging done at 1.5T in distinguishing bladder-restricted tumor from non-bladder-restricted tumor and compare the mean short axis dimension of metastatic pelvic lymph nodes with benign pelvic lymph nodes. Analytical study. Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, from March 2008 to July 2011. Patients with bladder cancer were enrolled. Based on pathologic T-staging following radical cystectomy, patients were assigned to one of two groups. Patients with stage T1 and T2 disease were assigned to the bladder-restricted tumor [BRT] group and those with stage T3 and T4 disease to the non-bladder-restricted tumor [NBRT]. High-resolution unenhanced MR imaging done prior to cystectomy was reviewed retrospectively [1.5 T MRI unit; GE Healthcare]. Results from MR imaging-based categorization were compared with pathology reports to fulfill the objective. Mean short-axis diameter of largest visible lymph nodes in patients with nodal metastasis was compared with mean short-axis diameter of largest visible lymph nodes in patients with benign lymph nodes. The accuracy of MRI in differentiating distinguishing bladder-restricted tumor from non-bladder-restricted tumor was 67.72%. The mean short axis diameter of metastatic lymph nodes was greater than that of non-metastatic lymph nodes, i.e., 7.4 mm and 5.4 mm respectively. Conventional high resolution 1.5T MRI does not appear to offer advantage over imaging done at low field strength scanners
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Aesthetic tooth selection and physiological tooth arrangement are the objectives of the complete denture fabrications. The objective of this study was to determine the relationship of the intercondylar width with mandibular inter-canine width. This cross-sectional comparative study was conducted in Department of Prosthodontics, Lahore Medical and Dental College, Lahore from January to June 2011. A total of 250 dentate subjects were selected according to the inclusion criteria. Maxillary and mandibular arch impressions were taken. The distance between the cusp tips of mandibular canines was measured by using vernier calliper. The inter condylar width was measured using arbitrary face bow. The width between the two condylar rods was measured with vernier calliper in millimetres. Every width was measured three times by the same operator to ensure the accuracy. Data recorded on the Performa for statistical analysis. Pearson correlation coefficients [r] for the inter condylar width and mandibular inter-canine are showing positive correlation and significant [r=0.24, p=0.0005]. Inter-condylar width provides significant measurements for the selection of anterior teeth in edentulous patients
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To compare the accuracy of Willis gauge and Sprung divider in determination of freeway space in dentate subjects. Cross-sectional comparative study. This study was carried out at Department of Prosthodontics, Lahore Medical and Dental College, Lahore from March 2010 to August 2010. Three hundred dentate subjects were included in this study. Both Willis gauge and Sprung divider methods were performed on same subject to measure the freeway space. Subjects were seated in comfortable upright position with unsupported head. Freeway space was measured by both Willis gauge and Sprung divider. The difference between the two measurements of rest position and maximum intercuspation was taken as freeway space. The collected data was entered in proforma. SPSS version 17 was used to analyze the data. Mean and SD was taken for age and gender. The measurement of both methods were compared through chi square test p value < 0.05 was considered significant. Out of 300 subjects, freeway space was achieved 217 [72.33%] with Willis Gauge and in 247 [82.33%] subjects freeway space was achieved with Sprung Divider. Although the achievement rate was slightly high with Sprig Divider as compare to Willis gauge method but it was non-significant [p-value = 0.078]. Sprung Divider measurement of freeway space is somewhat superior to Willis gauge
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Humans , Female , Male , Orthodontics , Cross-Sectional StudiesABSTRACT
The objective of this study was to determine the relationship of intercondylar distance with maxillary intermolar distance. It was cross-sectional comparative study and was conducted at the Department of Prosthodontics, Lahore Medical and Dental College, Lahore from June 2011 to November 2011. A total of 250 dentate subjects were selected according to the inclusion criteria. The impression of the maxillary arch was obtained using alginate. The vernier caliper was used to measure the distance between the mesiobuccal cusp tips of maxillary first molars. With the help of an arbitrary facebow the intercondylar distance was recorded. The distance obtained between the two condylar rods was measured in millimeters with the vernier caliper. Every distance was measured three times to ensure the accuracy and the mean was taken. The data were recorded on the proforma for the statistical analysis. Pearson correlation coefficients [r] for the intercondylar distance and maxillary intermolar showed positive correlation and significant [r=0.53 p=0.0005]. Intercondylar distance provides significant measurements for the arrangement of posterior teeth in edentulous patients
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The study intended to assess the prevalence of sports injuries among high school students. This cross sectional study was carried out using data from 300 students aged 9 to 18 years at Dubai International School and Universal American High School, UAE. A self-administered questionnaire was employed with open- and close-ended questions to collect the data. Data was analyzed using SPSS software version 19.0 and Chi-square test was applied to find the association between variables. The study population included 43.7% males and 56.3% females. Most of the students [74.3%] belonged to 13-15 year age group. More than half the respondents [58.3%] were in Grade 9. Over half the students [67.6%] had been injured during sports activities, the most common type of injury was sprains [34.5%]. Chi square test showed a significant association between history injury and participation [p<0.03]. Upon being injured medical treatment [66.7%] had been used as the most common option among the students. Sports injuries are common among the high school students. Therefore, awareness of possible sport injuries should be included in the school health programs
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The objective of this study was to find out the potential relationship of intercondylar distance with mandibular intermolar distance. It was a cross-sectional comparative study and was carried out from August 2011 to Jan 2012. The present study was carried out on 250 dentate subjects selected from the department of Prosthodontics, Lahore Medical and Dental College, Lahore. The orthodontically treated subjects and those with congenital or acquired orofacial deformities were also excluded. Al the subjects with a history of tempro-mandibulr joint dysfunction and pain were not included in the study. The impression of the maxillary arch was obtained using irreversible hydrocollide. The vernier caliper was used to measure the distance between the mesiobuccal cusp tips of mandibular first molars. The distance between both the condyles was recorded using an arbitary face bow. The intercondylar distance was measured in millimeters with the help of the vernier caliper. For accuracy every distance was measured three times by the same operator and the mean taken. For the statistical analysis the data was recorded on the proforma. The statistical results of the present study showed that the Pearson correlation coefficients [r] for the intercondylar distance and mandibular intermolar are showing positive correlation and significant [r=0.54 p=0.0005]. It was concluded that the Intercondylar distance measurement can be utilized for the arrangement of posterior teeth in edentulous patients
Subject(s)
Humans , Male , Female , Mandibular Advancement , Cross-Sectional Studies , Denture, Complete, Upper/standards , Denture DesignABSTRACT
The objective of this study was to determine the relationship of intercondylar distance with maxillary intercanine distance. It was a cross-sectional comparative study which was conducted in the Department of Prosthodontics, Lahore Medical and Dental College, Lahore from April 2011 to Sep 2011. A total of 250 dentate subjects fulfilling the inclusion criteria were selected. Upper and lower arch impressions were taken. Vernier caliper was used to measure the distance between the cusp tips of maxillary canines. Intercondylar distance was measured using arbitrary face bow. The distance between the two condylar rods measured in millimeters with vernier caliper. Every distance was measured three times to ensure the accuracy and mean taken. Data were recorded on the proforma for statistical analysis. Pearson correlation coefficients [r] for the intercondylar distance and maxillary intercanine showed positive correlation and significant [r=.24; p=00005]. It was concluded that Intercondylar distance provides significant measurements for the selection of anterior teeth in edentulous patients