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Objective: Correlation of CD24 expression with histological grading and TNM staging of retinoblastoma
Methods: This cross-sectional study was conducted in the Department of Pathology, BMSI, JPMC and NICH from 1[st] January 2009 to 31[st] December 2013. A total 68 diagnosed cases of retinoblastoma were selected for CD24 immuno staining. The data was analyzed by using SPSS version 22
Results: Out of 68 cases 7.35% showed grade 1 followed by 11.76% in G2, 26.47% in G3 and 54.41% in G4. Majority of cases i.e. 60.29% in stage IV followed by 19.11% in stage I, 10.29% each in stage II and stage III. CD24 immuno staining positivity was seen in majority of grade 3 and grade 4. In grade 3, 38.88% showed moderate and 22.22% strong immuno reaction. Amongst grade 4, 40.54% showed moderate and 13.51% strong positive. Variable immuno pattern was observed according to TNM staging. In stage I, 46.15% showed moderate and 7.69% strong positivity, while in stage II, 57.14% were negative for saining. In stage III, 42.85% were negative while 28.57% each showed moderate and strong staining. Majority of cases in stage IV i.e. 48.78% were negative for staining while 34.14%, 17.07% showed moderate and severe CD24 immuno staining
Conclusion: Majority of grade I retinoblastoma were in TNM stage I and II and mostly were immuno negative. Lymph node and distant metastatic cases were 75% in G4 and 25% in G3, all of them showed moderate to strong immunoreactivity. These results showed that CD24 expression may be a marker of poor prognosis in retinoblastoma. Whereas TNM staging of retinoblastomas with CD24 expression had varying pattern and showed no significant correlation between them
ABSTRACT
Objective: To compare the frequency of patients presenting with peptic ulcer disease [PUD] and peptic perforation during holy month of Ramadan with those presenting the month after Ramadan [Shawwal] in the Hijrah calendar and to assess the effect of risk factors on PUD and peptic perforation such as smoking, non-steroidal anti-inflammatory drugs usage, a previous history of acid peptic disease and the age groups and gender of patients
Study Design: Observational / descriptive study
Place and Duration of Study: This study was carried out in Medical and Surgical Units of KTH [Khyber Teaching Hospital] Peshawar from 2012 to 2014
Research Methodology: A total of 213 patients were included in this study presenting during this three years period. Patients were included or excluded according to a pre-set [inclusion or exclusion criteria]
Results: 62%[132] of all the patients presented during the three months of Ramadan as compared to 38%[81] of the patients presented three months after the Ramadan, x[2]=8.193, P value is 0.004205 and result is significant at p<0.05.Ninety six[46%] patients were smokers, 132[62%] of the patients were in the 20 to 40 year age group and male to female ratio was 5:1.Symptoms associated with peptic ulcer disease found in patients during Ramadan is more than after Ramadan
Conclusions: This study clearly showed the increased frequency of peptic ulcer disease and peptic perforation during the Holy month of Ramadan stresses on the need of precaution especially for smokers, non-steroidal anti-inflammation drugs users and patients with the history of acid peptic disease during this month
ABSTRACT
Objective: to determine the expression and localisation of the G[beta gamma]-activated adenylyl cyclase [AC] isoforms 2, 4, and 7 and calcineurin-inhibited AC isoform 9 in rat articular chondrocytes
Study Design: experimental study
Place and Duration of Study: Jumma Research Laboratory and Histology Laboratory, The Aga Khan University, Karachi, from 2009 to 2011
Methodology: fresh slices of articular cartilage were taken from various synovial joints of rats of different age groups. The expression of AC isoforms was determined by RT-PCR and immunohistochemistry was performed to localise these isoforms in articular chondrocytes. Tissue sections were processed for immunostaining with respective antibodies. The color was developed by diaminobenzidine
Results: all the studied AC isoforms were found to be differentially expressed in different zones of the rat articular cartilage. Generally, expression of all AC isoforms studied increased with age. The expression of the AC isoforms through PCR was almost consistent with the localisation of these isoforms by immunohistochemistry
Conclusion: these data add to the information about signalling cascades possibly involved in articular chondrocytes. Variable expression of AC isoforms 2, 4, 7, and 9 suggest a role for the signalling cascades regulated by the AC isoforms in articular chondrocytes
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Objective: The purpose of this study is, firstly, to find the pattern of ear diseases in the community, as no such pattern study is currently available. Secondly, to impart awareness regarding microscopic appearances of the common ear diseases encountered in this pattern study
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Surgical Pathology archives of the Laboratory of Charsada Teaching Hospital affiliated with Jinnah Medical College Peshawar from 2010 to 2015
Materials and Methods: In this study, all the cases of ear diseases from surgical pathology archives of the laboratory of Charsada Teaching Hospital were retrieved. All the slides and the diagnoses for the retrieved cases were reviewed by the histopathologist and the final diagnoses were recorded; the disease pattern was determined, keeping in view the number of cases for each diagnostic category and the patient's age
Results: The review of these cases between 2010 and 2015 showed that most of the biopsy specimens were from external ear while few were from the middle ear. The first five commonest conditions constituted almost two thirds of the total number of cases. The congenital anomalies and juvenile xanthogranulomas were most common in the first decade of life. Benign and malignant tumors were uncommon and seen mostly after the third decade of life
Conclusions: Congenital anomalies and inflammation associated diseases are common in the first three decades of life, whereas benign and malignant neoplasms are more common after the third decade of life
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Objective: To determine the gender differences in risk factors and patterns contributing towards deliberate self-poisoning. Methods: A descriptive study of patients admitted in National Poisoning Control Center Ward-5, Jinnah Post Graduate Medical Center Karachi, was conducted for six months from 1st July 2013 to 1st January 2014. The information was gathered using a questionnaire generated from World Health Organization, International Programme on Chemical Safety's INTOX [WHO IPCS INTOX] recording format for toxic exposure the data was analyzed on package SPSS version 14.0. The results were obtained in numbers and percentages. The Chi-square test was used for statistical differences of risk factors for deliberate self-poisoning in relation to gender. p-values of <0.05 were considered significant. Results: Out of the 374 patients analyzed during this period the age group most frequent was within the range of 15-74 years, with 61.5% of the subjects being male. No significant age difference was observed between male and female subjects. Single male subjects represented the largest population which attempted deliberate self-poisoning. History of psychiatric illness and drug abuse was more common in male subjects. There was no significant difference in educational status, agent used for Deliberate Self-Poisoning [DSP], number of agents used or route of exposure in the two genders. The agent most commonly used was organophosphate insecticide. Conclusion: Young single males belonging to low socioeconomic group and having history of psychiatric illness or drug abuse are at greater risk of Deliberate Self-Poisoning [DSP]. Preventive strategies need to be directed at this population
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Objective: The primary aim of our study was to determine the frequency of headache in medical students exposed to secondhand smoking, as well as observing response of non-smoker medical students for passive smoking
Methods: A cross-sectional study was conducted at three private colleges of Karachi in June 2014, sample size was 300. The inclusion criteria were medical students between 18-25 years of age who were non-smokers, exposed daily once or more to secondhand smoking. Students were inquired about age, gender, duration, location and frequency of exposure to passive smoking and presence or absence of secondhand smoking related headache and response and behavior of smokers observed by non-smoker students to counselling
Results: Out of 290 students 186 [64.1%] complained of headache related to passive smoking, 172 [59%] were exposed in medical colleges. Of 127 [43%] had been exposed to passive smoking more than two times a day. Although 255 [88%] out of 290 students favoured prohibition of smoking at public place, but only 90 [31%] did practical attempt to advise smokers to stop smoking at public place. Response of smokers was good, 73% students believed that smokers gave positive response to their advice
Conclusion: There appears to be a high frequency of headache related to secondhand smoking. Hence, students should be provided special training skills to council the smokers to avoid smoking at public place; moreover we also need practical implementation of laws against smoking at public place
ABSTRACT
To evaluate the optimum method of repair for inguinal hernia with respect to low rate of recurrence, minimum postoperative pain and cost effectiveness. Retrospective and Comparative study. This study was conducted between 2004-2007 in the surgical department DHQ Hospital Karak from. Either 320 patients were randomly allotted to mesh or non-Mesh repair. They were followed up at the 1[st] week and then 1, 6,12,18,24 and 36[th] month. Clinical outcome that is, recurrence rate, quality of life, Post-oparative pain etc were noted. After 3 year, the recurrence rates were significantly different for the two types of repairs. The Shouldice is usually suited in primary and unilateral inguinal hernial repair in adult males. In addition, The Lichtenstein is best for bilateral and recurrent inguinal hernial repair in old patients [>60 Yrs] and in elective states of repair
Subject(s)
Humans , Male , Female , Surgical Mesh , Pain, Postoperative , Cost-Benefit Analysis , Retrospective StudiesABSTRACT
World Health Organization [WHO] introduced hypertension as an epidemic in developing countries. However, hypertension is adequately controlled in only 12.5% of patients. The aim of this study was to evaluate the relationship between Ramadan fasting and mean arterial pressure [MAP]. This clinical, observational study was carried out at Medical O.P.D of Jinnah Medical College Hospital [JMCH], Korangi, Karachi, Pakistan. A total of 150 hypertensive patients [120 males and 30 females] and 150 healthy adults [75 males and 75 females] were evaluated during the month of Ramadan [from August to September 2010]. Blood pressure was measured in patients' right arm in the sitting position. The measurements were taken a week before Ramadan and during each week of this month. The average of measurements was calculated, and the results were analyzed by SPSS version 17. A reduction was observed in the MAP of hypertensive patients [from 117.3 +/- 4.2 in the first week to 108.3 +/- 4.2 in the fourth week]. In the control group, the MAP was 93.1 +/- 0.6 in the first week and 92.4 +/- 0.6 in the fourth week. This study showed that MAP reduces during Ramadan fasting. This effect of fasting may help control blood pressure in hypertensive patients
ABSTRACT
The present study was design to know the biochemical Risk Factors of the upper urinary Tract Stone Disease in the Peoples of Peshawar and Charsadda District. Observational Study. This study was carried out at District Head Quarter Teaching Hospital Charsadda and Naseerullah Khan Babar Memorial Teaching Hospital Kohat Road Peshawar from 12[th] August 2012 to 11[th] August 2013. One hundred subjects who were suffering from upper urinary tract stone disease were included in the study. The evidence of stone in the renal and history of spontaneous passage of stones in the urine were determined regarding Microscopic Examination. The age range of our subject was between 01 - 60 years. The mean age +/- S.D of age of stone former for men was 34.6 +/- 8.6 years and for female 30.8 +/- 6.7 in N.S.F. Family history of stone disease was found in [16%] of patients. 4% in maternal side and 12% paternal. The Serum Phosphate level was higher in S.F than N.S.F and is a risk factor for Upper Urinary Tract Stone Disease in Peshawar and Charsadda
ABSTRACT
To determine vaccination coverage against measles and the factors predicting it. Cross sectional, Analytic. This study was conducted at Peshawar District Khyber Pakhtunkhwa, Pakistan and the duration was 1[st] June 2014 to 20[th] June 2014. The study was carried on sample of 210 children in District Peshawar, Khyber Pakhtunkhwa, Pakistan. The district was first divided into clusters of 105. Out of these 21 clusters were randomly selected. Sample of 10 children aged 1-2 were randomly taken from each cluster. Cluster sampling technique was used and the data was collected by face to face interview using structured Questionnaire as tool. Overall vaccination coverage was 57.6% with a male to female ratio of 50.4% and 49.6% respectively. Mother's Education with vaccination status of Children suggests a strong relationship. Mothers with no education [illiterate] vaccinated 36.3% and mother with education [Literate] vaccinated 82.5% of their children. The Chi-square test is significant [X[2] =45.605; p-value .000]. Parents Education, Household Income and knowledge of mothers about measles vaccination age were found important predicting factors for vaccination status of children
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To assess knowledge of physicians of tertiary care hospitals of Peshawar about schizophrenia. Cross Sectional. This study was carried out at Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar from 10/09/2009 to 10/10/2010. It was cross sectional study conducted at tertiary care hospitals of Peshawar from 10[th] September to 2009 to 10[th] September 2010. 100 Physicians were asked to answer a Performa consisting of two portions namely, General Information and knowledge about Schizophrenia. Ninety Six percent of the physicians who participated in the study were males while four percent were female. Out of 100 physicians, 2% treated more than 10 patients annually, 3% treated 6-9 patients, 12% treated 3-5 patients and 13% treated 1-2 patients annually while 70% physicians didn't treat any diagnosed case of schizophrenia in a year. 6% of the physician diagnosed more than 5 new cases, 18% diagnosed 3-5 new cases and 42% diagnoses 1-2 new cases annually while 34% didn't diagnose any new case in year's time. 44% of physician had good knowledge about schizophrenia while 56% had poor knowledge. Most of the physicians have poor knowledge about schizophrenia
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To determine the frequency of urinary symptoms in postmenopausal women with Uterovaginal Prolapse. Descriptive study. This study was conducted in Department of Obstetrics and Gynecology Unit II, Dow University of Health Sciences and Civil Hospital Karachi Pakistan from July 2006 to June 2007/ 60 [sixty] Consecutive pts were included in the study through structural Proforma from the outpatient, ward or emergency. Informed consent was obtained. A detailed history and related examinations and investigations were done. These include Urine DR, Urine C/S and Urodynamics like cystometry in selected patients. Majority of Women found have symptoms were at the age of 60 yr [36.66%] While urinary symptoms less seen at the age of 80 yr [6.66%] while Parity 6-10 was higher in Postmenopausal women to have urinary symptoms [63.33%]. The urinary symptoms found in Postmenopausal women were frequent urine passing [33.33%], Nocturia [83.33%], Retention of urine [20.0%], Dysuria [26.66%], Voiding difficulty [53.35%], Urge incontinence [20.0%] and Stress incontinence [53.33%]. Pelvic organ Prolapse and urinary symptoms like incontinence are prevalent in older women and are associated with age. Large studies are required to assess the relationship of urinary symptoms with Uterovaginal Prolapse. Because these urinary symptoms effect over quality of life of women so it is recommended to reduce genital prolapsed and associated urinary symptoms by implementing some measures such as health education of women and weight control
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The objective of this double-blind, comparative study evaluating efficacy and biochemical effects of optimized felodipine 10mg [F-7] as monotherapy with comparison to placebo in adult patient with essential hypertension. Double-blind, comparative study. This study was conducted at the Department of Biochemistry, University of Karachi from March 2011 to October 2011. This was multicenter randomized, double-blind, comparative study. Patients were randomized to receive once Felodipine [F-7] daily for 8 weeks and at the end of study efficacy and biochemical evaluation was done. The patients treated with optimized Felodipine 10mg [F-7] alone, blood pressure reduction was lower, although significant; reaching values of 140.2 +/- 11.3 /87.9 +/- 5.5 mmHg [p < 0.05 versus Placebo] by the end of eight weeks of treatment. No significant variation of blood glucose was observed and different parameters of lipid profile were also observed during the eight weeks of treatment with antihypertensive regimen used. Thus, the drug regimens used may be considered neutral as regards glucose and plasma lipid metabolism profile because drug used at low doses. We can suggest that the high antihypertensive efficacy, good tolerability and no biochemical effects of the optimized Felodipine 10mg [F-7] it is an excellent option for the treatment of hypertension in a wide range of hypertensive patients, with a high potential to reduce cardiovascular risks
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The objective of this double-blind, Placebo control study evaluating efficacy and biochemical effects of optimized Atenolol 50mg [F-9] as monotherapy in adult patient with essential hypertension. Double-blind, Placebo control study. This study was conducted at the Department of Biochemistry, University of Karachi from February 2011 to September 2011. This was multicenter randomized, double-blind, Placebo control study. Patients were randomized to receive once Atenolol [F-9] daily for 8 weeks and at the end of study efficacy and biochemical evaluation was done. The patients treated with optimized Atenolol 50mg [F-9] alone, blood pressure reduction was lower, although significant; reaching values of 140.9 +/- 11.31 m88.9 + 5.5 mmHg [p <0.05 versus Placebo] by the end of eight weeks of treatment. No significant variation of blood glucose was observed and different parameters of lipid profile were also observed during the eight weeks of treatment with anti hypertensive regimen used. Thus, the drug regimens used may be considered neutral as regards glucose and plasma lipid metabolism profile because drug used at low doses. We can suggest that the high antihypertensive efficacy, good tolerability and no biochemical effects of the optimized Atenolol50mg [F-9] it is an excellent option for the treatment of hypertension in a wide range of hypertensive patients, with a high potential to reduce cardiovascular risks
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The objective of this double-blind, comparative study evaluating efficacy and biochemical effects of optimized Valsartan 80mg [F-3] as monotherapy in adult patient with essential hypertension. Double-blind, comparative study. This study was conducted at the Department of Biochemistry, University of Karachi from January 2011 to September 2011. This was multicenter randomized, double-blind, comparative study. Patients were randomized to receive once Valsartan [F-3] daily for 8 weeks and at the end of study efficacy and biochemical evaluation was done. The patients treated with optimized Valsartan 80mg [F-3] alone, blood pressure reduction was lower, although significant; reaching values of 140.9 +/- 11.3 / m88.9 +/- 5.5 mmHg [p < 0.05 versus Placebo] by the end of eight weeks of treatment. . No significant variation of blood glucose was observed and different parameters of lipid profile were also observed during the eight weeks of treatment with antihypertensive regimen used. Thus, the drug regimens used may be considered neutral as regards glucose and plasma lipid metabolism profile because drug used at low doses. We can suggest that the high antihypertensive efficacy, good tolerability and no biochemical effects of the optimized Valsartan 80mg [F-3] it is an excellent option for the treatment of hypertension in a wide range of hypertensive patients, with a high potential to reduce cardiovascular risks
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To compare the proportion of urinary symptoms in pre and postmenopausal women with Uterovaginal prolapse. Comparative Study. The study was carried out at the Department of Obstetrics and Gynecology Unit II, Dow University of Health Sciences and Civil Hospital Karachi from July 2005 to January 2006. Sixty consecutive patients [30 premenopausal and 30 postmenopausal] were included in the study through structured Proforma from the out patient ward or emergency. Informed consent was obtained. A detailed history and related examinations and investigations were done. These include urine DR, Urine C/S and Urodynamic like Cystometry in selected patients. In this study the difference of urinary symptoms in pre and postmenopausal women of Uterovaginal prolapse were statistically found insignificant like frequency of urine [26.7% versus 33.3%], Urgency [20% vs 26.7%], Nocturia [26.7% vs 13.3%], Dysuria [40% vs 26.7%], Voiding problems [40% vs 46.7%] Urge incontinence [40%vs 20%]. Stress incontinence was slightly higher in postmenopausal group than premenopausal [53.3%vs 46.7%] but this difference was found insignificant, while parity status between these two groups had significant difference like parity 2-5 was higher in pre-menopause group than postmenopause [66.7% vs 36.7%] and parity 6-10 was higher in postmenopause group than pre-menopause [63.3% vs 26.7%]. Significant difference in parity was found between pre and post-menopausal women with Uterovaginal prolapse but the difference of urinary symptoms in pre and postmenopausal group was found significant. Uterovaginal prolapse associated with different urinary symptoms especially incontinence and voiding problems. These urinary symptoms effect over quality of life of women. This warrants greater attention for Gynecological health needs in our country by safe family planning practices
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Validity of pleural fluid protein in differentiating tuberculouse from malignant pleural effusion keeping histopathology as gold standard. Cross sectional study. This study was conducted in the Pulmonology department post graduate medical institute, Lady Reading Hospital Peshawar, Khyber Pakhtunkhwa [KPK] Pakistan from March 2009 to March 2010. One hundred and seventy nine patients having clinical suspicion of pulmonary tuberculouse and malignancy and fulfilling the inclusion criteria were subjected to Abrams needle biopsy, plural tissue was examined by histopathology. Biopsy in order to know the significant difference of pleural fluid protein level between tuberculous and malignant pleural effusion, histopathology finding and protein concentration were determined their frequency and percentage. Among total number of 179 patients one hundred and fourteen [63.69%] were male and sixty five [36.32%] were female. The age limit from 15-80 years, the result shows that 60.9% were tuberculous and 39.9% were malignant pleuraleffusion, among these malignant 20 [11.2%] showed primary and 50 [27.9%] secondary malignancy. Tuberculous PE was more common in younger age group while malignant PE in older age group, 32 number of patients falling in category A, 59 in category B, and 88 in category C.A protein level in belonging to category C, there was statistically significant difference between tuberculous and malignant PE, tuberculous PE have high concentration of protein than malignant PE, The category [A] have malignant PE. Plural fluid total protein level determination and differentiating is a valuable tool in reaching to the diagnosis of suspectedtuberculouse from malignant pleural effusion provided it is used in addition to the adequate clinical scenario
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Objective: To evaluate the optimum surgical technique for inguinal hernia repair, Shouldice or Bassini's. Study Design: Retrospective comparative study. Place and Duration of Study: This study was conducted between 2004 to 2006 in the surgical ward DHQ Hospital Karak. 200 patients with unilateral and primary inguinal hernia were randomly allotted to either Shouldice or Bassini's repair. The cases were collected either as emergencies or electively. Materials and Methods: All the patients had primary and unilateral inguinal hernia. They were operated electilively or as emergencies. Patients were randomly allotted to either Shouldice or Bassini's repair. The Shouldice was performed with 210 prolene in four layers while the bassini's repair was done with prolene 0 or 1. Results: The patients operated for inguinal hernia were followed for up to 5 years. The shouldice repair was found associated with a lowest recurrence rate of 3% and the Bassini's repair with 5.7%. The difference remains statistically significant [P<0.001]. Conclusion: The Shouldice repair for inguinal hernia was associated with a recurrence rate of less than 1% in the Shouldice clinic at TOR ONTO
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This study was planned to find out the clinical presentation and postoperative outcome of different surgical procedure in low type in low fistula in Ano. Prospective observational study. Study was conducted in teaching hospital setting at LUMHS Jamshoro, Zia ud Din Teaching Hospital Karachi and DHQ JMC Teaching Hospital Charsadda. Liaquat University in Surgical Unit-1 Jamshoro from May 2010 to June 2012. One seventy cases of low type fistula in Ano with single external opening, irrespective of age and sex admitted in surgical unit-l, were examined. Mean age was 37 years, patient's rages from [15-60 years]. Patients having high type fistula in ano identified pre and per operatively excluded from the study. A detailed history physical examination including local examination of anorectum focusing on the level of internal opening. Investigation like fistulogram done in selected case. Fistulectomy and fistulotomy performed in all these cases and patient followed up minimum upto the 6 months time. Maximum Number of cases were seen in 3rd,4th, decade of life 50 [29.6%] and 64 [37%] respectively. Mean age was 37 ranges from 15 to 60 years. Out of 172 patients 142 [85.7%] male and 24 [14.3%] female. Male to female ratio was 6.1:1. Majority of patients one forty two [82%] presented with discharge. Discharge along with swelling in 132 [76.7%]. Hundred twelve [65%] underwent fistulectomy, 38 [22%] of the patients got fistulotomy and [12%] of patients underwent fistulectomy along with haemorrhoidectomy and fissurectomy. A total of 72 [41.4%] patients experience different post operative, surgical and anesthetic complications. Conclusions: Incidence of low type fistula in ano is higher in 3rd and 4th decade of life. The disease was found more common in male, discharge, pain, itching are common symptoms of low type fistula in ano. In low type fistula in ano fistulotomy is safe procedure. Post operative complications can be prevented by careful treatment efforts