Clinicopathological spectrum of gall bladder cancer in Kashmir - an institutional study

Gallbladder cancer is a highly aggressive malignancy that usually presents at an advanced incurable stage. It is the fifth most common gastro-intestinal tumor and leads to approximately 2800 deaths in United States annually. This was a retrospective study carried out in the Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, a 650-bed super speciality hospital in Kashmir valley. We reviewed the histopathological records of all the patients who were diagnosed as carcinoma gallbladder from Dec 2009-Dec 2013. Gross findings and histopathological findings were noted from the departmental archival material and clinical records of the patients including the clinical presentation, laboratory investigations, radiological investigations, pre-operative diagnosis and intra-operative findings, were retrieved from the hospital records. We analyzed 57 cases of carcinoma gallbladder for their clinicopathological features It included 19 males and 37 females. In our study, adenocarcinomas accounted for 87.5% of total carcinomas. Incidentally, all but one patient where gall stones were found, adenocarcinomas were seen. We have 4 patients of squamous cell carcinoma. In our series we have a single case of small cell carcinoma which was positive for neuroendocrine markers. In our study, gall stones were seen only in 8 cases [14%] of the total cases

Living donor renal transplantation our experience in SIMS/Services Hospital, Lahore

Kidney transplantation is the treatment of choice for end stage renal disease [ESRD] patients. However organ shortage remains the central problem in kidney transplantation. To deal with the widening gap between supply and demand of organ for renal transplantation, efforts to expand the organ donor pool have received increased attention. To solve this problem, we have initiated a living related and unrelated living donor programe using emotionally related persons, friends and well motivated volunteers as organ donors. A total of 18 patients with live donor underwent kidney transplantation in Sims /Services Hospital over a period from March 2006 to December 2006. The aim of study is to highlight the problems and identification of factors limiting the number of transplantation and further prospects of renal transplantation in Pakistan. The cause of ESRD was HTN 7 [38.89%], Chronic Glornerulonephritis 4 [22.22%], Calculus Renal failure 4 [22.22%], and Diabetic Nephropathy 3[16.67%].The donor age ranged between 20-55 years [mean 28.39].The recipient age ranged 17-56 years [mean32.73]. Relationship of donor to recipient was sister 1 [5.56%], 1st degree relatives 3 [16.7%], friends 4[22.22%], unrelated 10[55.56%]. In our study graft survival was 88.89%, patient survival 94.45%, mortality 5.56%. Transplanted patient has to be better motivated to take medication regularly and get the investigations. It was observed that 1st degree relation are very limited source of donors in this part of the world and unrelated donors certainly encourage, transplantation

Responses of glutathione to brief exercise in diabetes mellitus

Glutathione [GSH] acts as a substrate for glutathione peroxidase to remove peroxides and serves as scavenger for hydroxyl and oxygen free radicals, and prevents oxidation of hemoglobin to methemoglobin in red blood cells [Halliwell and Gutteridge, 1985]. Tissue GSH status, i.e., the concentrations and ratio of GSH and glutathione disulfide [GSSG] is known to be changed by oxidative stress induced by strenuous exercise [Lew et al., 1985]. Previous reports indicated that blood concentration of GSH is decreased, whereas GSSG levels are elevated significantly after acute exercise [Lew et aL, 1985]. However, the mechanism for the observed changes in GSH oxidoreductive status and contents with exercise is unknown. GSH is mainly synthesized in the liver and released to the blood [Meister and Anderson, 1983]. The uptake of GSH by peripheral tissues involves many enzymes [Meister and Anderson, 1983]. Release of GSH from the liver during exercise is controlled by some hormones like glucagon, and resulted in elevation of GSH concentration in skeletal muscle [Meister and Anderson, 1983]. The purpose of this study is to determine, if acute brief exercise alters the contents and oxidoredox status of erythrocytes GSH in healthy humans and compare these responses of GSH to diabetic patient

Haplotypes of the beta-globin gene as prognostic factors in sickle-cell disease

We collaborated with researchers from Egypt, Syrian Arab Republic and Jordan in a study of patients with sickle-cell disease from those countries, and from various parts of Saudi Arabia, in order to investigate the influence of genetics on the clinical presentation of the disease, and to attempt to determine the origin of the sickle-cell gene in Arabs. Our results suggest that beta-globin gene haplotypes influence the clinical presentation of sickle-cell disease, and that there are at least two major foci for the origin of the sickle-cell gene, one in the eastern part of Saudi Arabia, and the other in the populations of North Africa and the north-western part of the Arabian peninsula

Prevalence of thalassaemia in schoolchildren in north-eastern Badia, Jordan

The prevalence of the different types of thalassaemia and that of iron deficiency anaemia was investigated in 1020 schoolchildren [age range: 6-15 years] from the north-eastern Badia region of Jordan. beta-thalassaemia minor was the most prevalent [3.04%], followed by alpha 2-thalassaemia [2.06%]. Only three cases of alpha 1-thalassaemia and one case of beta-thalassaemia major were found. Iron deficiency anaemia was diagnosed in 54 children [5.3%] [33 males, 21 females]. The mean values of the blood characteristics of the normal, haemoglobinopathic and iron-deficient children were examined and compared