Demographic Profile of Cervical Cancer: A Retrospective Study Conducted in Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

Introduction: Worldwide, cervical cancer remains the most common gynecological cancer and the fourth most commonmalignancy in women, with over 526,000 women globally developing this tumor as reported in 2015 and 239,000 women dyingof the disease every year. To date, there are limited data of cervical cancer in Kashmir, India.Objectives: The aim of the present study was to analyze the demographic spectrum of cervical cancer in Kashmir.Materials and Methods: This was a retrospective study. All the patients who had histopathologically confirmed cervical cancer,registered at Regional Cancer Center of Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, were included, between2008 and 2015. All the patient characteristics including age, presentation, type of cancer, stage of cancer, parity, and treatmentreceived in each case were studied in detail.Results: The present study included 120 patients of cervical cancer. The median age of patients was 51 years. Majority of ourpatients were multiparous (88.3%) and from a rural background (74%). The most common presenting complaint was abnormal vaginalbleeding (70%) followed by abdominal pain (19%). Squamous cell carcinoma was the most common type of cervical carcinomaseen in 95% of patients followed by adenocarcinoma (5%). Most of the patients (66.67%) presented at late Stages (II, III, and IV).Conclusion: Early detection will reduce the number of deaths of cervical cancer patients. Asignificant number of cervical cancer patientsin Kashmir present with an advanced stage of disease. Cervical cancers are observed at a middle age group that is >40 years of age.People should be educated for an early consultation for symptoms, and high-risk individuals should be encouraged for screening. Thehealth programs about cervical cancer should be carried out in open places to give more information about cervical cancer to the public.

Synergistic interactions of polyphenols and their effect on antiradical potential

The aim of the current study was to evaluate interactions among polyphenols from different plants and their effect on antioxidant potential. Different mixtures of plant extracts of Crataegus oxyacantha [C], Elettaria cardamomum [Cr], Terminalia arjuna [T] and Rauvolfia serpentina [R] were prepared and evaluated for total phenolics, flavonoid contents, and antioxidant activity. A correlation was also established between total phenolics, flavonoids and antioxidant activity. Comparative evaluation revealed that phenolics, flavonoids and antioxidant activity were found high in plant extracts mixtures than individual plants. Highest phenolics [580+/-1.12mg GAE/g], flavonoids [67.10+/-0.11mg CE/g] and antioxidant activity [IC[50] 0.109mg/ml] was observed with ratio 1:1:1:2 of plant mixture C, Cr, T, R. A weak linear positive correlation was found between antioxidant activity, total phenolic and flavonoid contents. A negative correlation was observed among IC[50] value, total phenolics and flavonoid contents. Investigation through RP-HPLC revealed the presence of different potent phenolics in plants understudy. More antioxidant potential of extracts in combinations as compared to that of individual plants was clear corroboration of synergism. The ratio [1:1:1:2] of the studied plants in combination, that showed the highest free radical potential, was another expected better pharmacological prospect. This formulation can bring maximum relief against free radical-associated diseases

Age of Onset of Puberty in Apparently Healthy School Girls from Northern India.

Objective: To determine the age of pubertal onset and menarche in school-going girls, and to assess the impact of obesity on pubertal timing. Design: Cross-sectional Setting: Seven schools across Delhi, India. Participants: 2010 school girls, aged 6-17 years Methods: Anthropometric measurement and pubertal staging was performed for all subjects. Menarche was recorded by ‘status quo’ method. Body mass index was used to define overweight/obesity. Serum gonadotropins and serum estradiol were measured in every sixth participant. Main outcome measure: Age at thelarche and menarche—analyzed for entire cohort and stratified based on body mass index. Results: Median (95% CI) ages of thelarche, pubarche and menarche were 10.8 (10.7-10.9) y, 11.0. y (10.8-11.2) y and 12.4 y (12.2-12.5) y. Overweight/obese girls showed six months earlier onset of thelarche and menarche than those with normal BMI (P<0.05). Serum gonadotropins did not vary significantly in overweight/obese subjects. Conclusion: The study provides the normative data for pubertal growth in Indian girls. Pubertal onset occurs earlier in overweight and obese girls.

Incomplete Kawasaki Disease in a Three Month Old Infant.

Kawasaki disease (KD) is an acute systemic vasculitis of unknown aetiology that has largely replaced rheumatic heart disease as a cause of acquired heart disease in children of many developed countries. We report a case of incomplete KD in a threemonth- old girl. The diagnosis of incomplete KD was made after exclusion of conditions with similar presentation. She was treated with intravenous immunoglobulin following which she made an uneventful recovery but demonstrated thrombocytosis in the second week of convalescence. It is important for the treating physicians to become aware of the incomplete KD as prompt diagnosis and early treatment of these patients with intravenous immunoglobulin is vital for the prevention of lethal coronary complications. Physicians need to have a "high index of suspicion" for KD and even, higher for IKD.

algorithm for estimating suspended sediment concentrations in the coastal waters of India using remotely sensed reflectance and its application to coastal environments

This study presents an empirical relationship of suspended sediment concentrations [SSCs] in the coastal waters, which is derived from the conventional methods, to radiometer remote sensing reflectance values [R[rs]] and satellite data in coastal waters of Kerala. An algorithm is then developed to utilize both in situ SSCs measured from conventional methods and R[rs] values. This algorithm is validated with the SSCs retrieved from Oceansat-2 Ocean Colour Monitor [OCM] data. A significant coefficient of determination [R[2]=0.62] is observed between the SSCs measured in situ and satellite derived SSCs. Reflectance values from more than two spectral wavelength bands are also employed to test the accuracy of results. Satellite derived SSCs range from 1- 40 mg/L in the coastal waters off Cochin, southwest India. The regional algorithm developed for the study area gives better results than Tassan's algorithm, and this algorithm can be used in estimation of SSC for coastal waters of western India

Seroprevalence of dengue fever [IgG] in adults of rawalpindi district

Objective: The objectives of current study were to find out the prevalence of Dengue viral infection [DVI] IgG amongst the adult population residing in urban/ rural areas of Rawalpindi in order to assess that in which specific population it is more prevalent. The hypothesis of the study was that DVI is more prevalent in urban areas of Rawalpindi district

Study Design: Descriptive Cross Sectional Comparative Study

Place And Duration: It was carried out at Microbiology Department of Benazir Bhutto Hospital Affiliated with Rawalpindi Medical College, Rawalpindi. It was carried out from March to September 2010

Methodology: Stratified random sampling procedure was adopted for 240 healthy adults, 144 urban residents and 96 rural residents of Rawalpindi. The clotted blood samples were used for the detection of anti-dengue Ab [IgG] by 3[rd] generation ELISAmethod

Results: The results were in favor of the hypothesis showing 34.7 % prevalence of DF in urban areas when compared to 19.7% prevalence in rural areas of Rawalpindi

Conclusion: Dengue fever is more prevalent in urban areas of Rawalpindi

Need for chest tube after video assisted thoracoscopic [VATS] lung biopsy

To observe the effects of early removal of chest tube drain after video assisted thoracoscopic [VATS] lung biopsy. We prospectively evaluated the removal of chest tube drain at six hours or 24 hours after the VATS-lung biopsy in fifty consecutive patients with no evidence of air leak after the lung biopsy. Our results show that removal of chest tube drain at 6 hours was not associated with complications such pneumothorax, atelectasis or pleural effusion as compared to the 24 hours removal of the drain[p>0.05]. Early removal of chest tube drain is safe in patients where air leak has been documented to be absent. Since it was a non-randomized evaluation, further randomized study in our population is needed to confirm these findings

Outcome of bilateral ureteroscopic retrieval of stones in a single session

Evaluation of bilateral ureteroscopic retrieval of stones as a single-stage procedure in terms of clearance of the stones, complications of the procedure and duration of hospital stay. A successful outcome was considered when both ureters were free of stones without any major complications. A total of 60 patients with bilateral ureteric stones were treated ureteroscopically from March 2006 to September 2009 in the department of Surgery [Urology unit]. Majority of the patients were in their third and fourth decade of life with 38 males and 22 females. A single session bilateral ureteroscopic retrieval of stones was done using a 7.8 Fr semirigid ureteroscope. A 0.038-inch guide wire was used and advanced under direct vision, and monitored by C-arm X-ray image intensifier. Balloon dilatation of the intramural ureters was required in 82 renal units. The stones were either extracted directly or disintegrated into small pieces by lithotripsy [pneumatic] before extraction. Ureteric stenting was required in 39 patients. Patients were followed for a period of 3-12 months. A total of 60 patients [120 renal units] with bilateral ureteric stones were treated ureteroscopically. The stone size in the treated patients was in the range 6-20 mm. The stones were radio-opaque in 47 patients and radiolucent in 13 patients. Single stone was present in all except two patients. Operative time ranged between 40 and 120 minutes. Stones were completely removed in 51 [85%] patients following single-session procedure of which 39 [76.4%] were stonefree intraoperatively and another 12 [23.5%] were cleared of the stones in 4 weeks follow-up. Six patients were stonefree unilaterally. Failed procedures were managed with repeated ureteroscopy, DJ stenting and ESWL or open ureterolithotomy. Intraoperatively false passage or minor ureteric perforations were seen in six patients. Postoperative complications included abdominal pain in 10, persistent fever in 4 and hematuria in 2 patients. No long-term complications were observed. Most of the patients were discharged in 2 days. Bilateral same-session ureteroscopy is a safe and effective procedure in the management of bilateral ureteral stones. The results are comparable to unilateral or staged bilateral procedures

effect of multiple risk factors on the severity of coronary artery blockage among the patients who had undergone angiography in the cardiology unit of JHL

Coronary artery disease [CAD] is the leading cause of mortality in the elderly. Traditional cardiovascular risk factors [CVRFs] such as advancing age, diabetes mellitus, hypertension, dyslipidemia, smoking, obesity, and family history of CAD are well recognized for their association with clinical events and acute coronary syndromes; however, the correlation between CVRFs and atherosclerotic burden, assessed angiographically, is not as well established, with the studies reporting variable and inconsistent results. To study the effect of multiple risk factors on the severity of coronary artery blockage among the patients who had undergone angiography. A Descriptive Cross Sectional Study. This study was carried out at Cardiac unit Jinnah Hospital Lahore from May 2010 to July 2010. The study included 120 patients undergoing angiography and were assessed for severity of risk factors. Cross tabulation was performed with dependent variable, severity of coronary artery disease and independent variables like familial tendency, smoking, Diabetes, hypertension, obesity and high cholesterol level. Chi square test was applied to see statistical significance. severity of coronary artery disease was assessed by number of coronary vessels involved. Vessels with more than 50% blockage on angiography were labeled as blockade. Among them 42% of the subjects had one vessel involved and 78% of the subjects had more than one vessel involved. Mean age of subject were 53.0 yrs with SD + 11.7. 76.7% were male and 23.3% were female. 49.2% had familial history of Coronary artery disease 66.7% were smokers. 38.3% of subjects had diabetes mellitus. 68.3% of the subjects had hypertension. 37.5% of the subjects were overweight. 17.5% of the subjects had cholesterol level > 250 mg/dl 75.8% of the subjects had a proximal blockade, 20.0% had a distal blockage and 4.2% had both proximal and distal blockage. Smoking, duration of smoking, number of cigarettes smoked per day and obesity are positively associated with severity of coronary artery disease and are statistically significant [P<.05]. While high cholesterol level, diabetes and Hypertension had a non-significant relationship in our study. There is a significant association between the severity of risk factors and the severity of coronary artery disease. The association of Smoking, duration of smoking, number of cigarettes smoked per day and obesity with severity of coronary artery disease is statistically significant [P<.05]

Demographic and clinicopathological parameters in lung cancer in a chest hospital, Lahore - Pakistan

We are presenting the clinical and pathological characteristics of lung cancer among patients reporting to Gulab Devi Chest Hospital Lahore, the largest and the oldest health care facility for chest diseases including lung cancer in Pakistan. It was a cross - sectional, descriptive study conducted at the department of histopathology, Gulab Devi Hospital Lahore between March 2011 and February 2012. A sample of 293 patients of primary lung cancer was taken. The demographic and clinical details i.e. age, sex, history of smoking and presenting symptoms were collected after the informed consent. Histopathological diagnosis and tumour grades were added in respective columns. Data was analysed with the help of S.P.S.S. version 17.0. Mean age was 53.19 +/- 0.92 years for male and 47.36 +/- 1.92 years for females. Male to female ratio was 3:1. History of tobacco smoking was present in 2/3[rd] of the patients. Smoking was strongly associated with squamous and small cell carcinoma of lung. Most common histological diagnoses were squamous cell, small cell and adenocarcinoma respectively. Majority of squamous cell carcinoma were poorly differentiated as compared to adenocarcinoma in which well and moderately differentiated tumours constituted 25% and 45% respectively. Most of patients presented at inoperable stage. Smoking is most strongly associated with the two most common histological entities of lung cancer viz. squamous cell carcinoma and small cell carcinoma. Bronchial biopsy was the commonest diagnostic procedure in practice and surgical resection is offered to only a few cases

Profile of Acute Renal Failure in Children in Kashmir.

We report on the etiology and the short term outcome (3 month) of children with acute renal failure (ARF) at a tertiary care centre in north India. Acute tubular necrosis was the commonest cause of ARF (33%) especially in children <5 years of age; while in children >10 years, glomerulonephritis was the commonest cause. The overall mortality rate was 20%.The outcome at 3 months showed normal renal function in 72 patients and CKD in 5 patients. Three patients were lost to follow-up.

Surgical audit of 86 patients of tm joint bony ankylosis treated at a tertiary care hospital in Srinagar

The authors present a review of 86 patients with bony ankylosis of Temporomandibular joint treated between Jan 1990 and Dec 2005 at a tertiary care referral hospital in Srinagar. Childhood trauma was the leading cause of ankylosis. For initial 50 patients of the series, acrylic spacer was used as interpositional material, and for the rest of patients, silicone block was used. Follow-up evaluation ranged from 14 months to five years [average 31 months]. Recurrence was observed in 5 patients [all in acrylic group]. There was statistically no significant difference in post operative mouth opening and other complications between the two groups. The aim of the study was to analyze the treatment outcome of the patients with TMJ ankylosis

Multiple Enchondromatosis: Ollier's Disease.

Multiple enchondromatosis (Ollier's disease) is a rare disease characterized by widespread enchondromas with a unilateral predominance, especially in fingers in early childhood. In general, the short tubular bones of the hand are involved, with progressive lesions resulting in cosmetic problems and functional deformities. Herein, we, describe two cases of Ollier's disease diagnosed on X-ray of hands followed by MRI. There was no evidence of cortical disruption or periosteal reaction associated in either case. The bone lesions revealed cartilaginous matrix. MRI using conventional T1W and T2W sequences and STIR showed expansile lesions within the metacarpals and phalanges of both hands with cartilaginous matrix.

Immunohistochemical expression of cytokeratin-19 in non small cell lung carcinomas - an experience from a tertiary care hospital in Lahore

Previous literature reveals a significant recognition of Cytokeratin [CK] 19 as a reliable tumour marker in epithelial malignancies. With the hypothesis that CK 19 is extensively released by the tumour cells in patients with non small cell lung carcinomas [NSCLCs], this study was designed to assess [1] the clinicopathological characteristics of lung cancer in this sub-region [2] the pattern of immunohistochemical expression of CK-19 in different NSCLC subtypes with respect to their histological grades. A cross-sectional descriptive study comprising of detailed account of clinical data of 225 patients presenting with NSCLCs. After H/E staining, immunohistochemistry [IHC] was performed using prediluted ready to use mouse monoclonal antibody to CK 19. Our findings of the study revealed that the mean age of the patients was 45 years with the male to female ratio being 5:1. Most prevalent type seen was squamous cell carcinoma [SCC] and adenocarcinoma [AC] in males and females respectively. Some cases were not easily classifiable as squamous or adenocacinoma and hence they are classified as NSCLs Unclassified. SCC was commonly associated with smoking in both genders. Immunohistochemical staining of the histological tissue sections of 93.7% NSCLCs demonstrated a varying immunopositivity while showing strong, diffuse to focal cytoplasmic staining of the tumour cells. A significant association [p=0.001] was found between the increasing grades of malignancy and the strength of CK-19 expression. Supporting the previous literature, we have also come across that CK-19 is credibly expressed in patients with NSCLCs and may be applied as a reasonably reliable immunohistochemical marker. In future the patients over expressing CK-19 histologically might constitute potential candidates to be followed up through non invasive serial serum levels estimation intended for assessment of tumour burden in recurrence or advanced disease

Periodontal conditions in pregnant and non - pregnant women in Karachi

The objective of the study was to compare the effectiveness of clinical plaque treatment removal in pregnant and non-pregnant females in Karachi, Pakistan. A quasi experimental study was designed with a sample size of 108 women, both pregnant and non-pregnant. Three antenatal clinics from different areas of Karachi were selected. Total duration of study was two and a half years. A total of 86 pregnant females were selected along with 22 non-pregnant females by random sampling. Pregnant females in the first trimester were placed in group-A while from second trimester in group-B. A control group of non-pregnant females were placed in group-C. Groups A and B were given half mouth treatment for the first month. They were retreated with complete mouth therapy in the second month. Groups C were given a full mouth treatment. CPI [Community Periodontal Index] and PU [Plaque Index] were recorded. All subjects were put on a maintenance regimen of Triclosan containing tooth paste. Significant changes in Plaque Index [PLD and Community Periodontal Index [CPI] were recorded after plaque removal. Half mouth plaque removal resulted in a better outcome regarding gingival health and plaque severity in Group A and B as compared to Group C [p<0.05]. Intervention [in terms of plaque removal and triclosan dentifrice] resulted in a significant reduction in PLI and CPI scores in all groups. The intervention by plaque removal at early stage of pregnancy along with maintenance with triclosan had resulted in a more favorable outcome regarding gingival diseases and plaque

Lethal Midline Granuloma Presenting as Facial Cellulitis.

Lethal midline granuloma (Midline granuloma, Midline reticulosis, Polymorphic reticulosis, and Angiocentric immunoproliferative lesion) is relatively a rare entity of unknown etiology characterized by a massive destruction, erosion and mutilation of the tissues of nose and upper respiratory passages. Unlike Wagner’s granulomatosis which is known for its multi organ involvement, lethal midline granuloma remains usually localized. Without therapeutic intervention it has a very high mortality. Radiotherapy is the treatment of choice which considerably improves both quality and quantity of life. Addition of chemotherapy gives additional benefit. Sporadic cases have appeared in literature from time to time under various synonyms.