Diagnostic accuracy of fine needle aspiration of thyroid nodule verses biopsy in thyroid lesions

FNA biopsy of thyroid is a rapid, minimally invasive, and cost effective first line procedure in the evaluation of thyroid nodule. This study was conducted to evaluate the cytological accuracy, sensitivity and specificity of fine needle aspiration [FNA] of solitary thyroid nodules in correlation with post-surgical histological findings. This retrospective study was carried out at Department of Pathology, Abbottabad International Medical College, Abbottabad from January 2009 to December 2010. A total of 81 patients with clinically palpable solitary thyroid nodule were included in the study. Thyroid function tests were initially performed followed by FNA of thyroid nodules later operated and histopathological examination was conducted on the excised nodules. FNA diagnoses were correlated with the histological findings. The accuracy, sensitivity and specificity of the procedure were determined. Out of 81 cases, 5 [6.2%] were unsatisfactory and 76 cases were satisfactory for cytological evaluation. Cytohistopathological correlation was carried out for these cases. The study showed a diagnostic accuracy of 93% with sensitivity and specificity rates of 75% and 96% respectively. Positive predictive value is 81% and negative predictive value is 95%. Fine needle aspiration [FNA] has evolved as an accurate and sensitive diagnostic tool for the initial screening of patients with thyroid nodules, and has reduced the need for unnecessary surgery

Frequency of tetanus toxoid immunization among college/university female students of Karachi

Tetanus is a deadly infectious disease for which immunisation is available in EPI at both infant level and for females of reproductive age. More than 95% of patients who develop tetanus have not been previously immunised. Objectives of the study were to determine the frequency of tetanus vaccination and to access the awareness of immunisation among females studying in 11 girls' colleges of Karachi and University of Karachi. A cross sectional study was conducted among 1,407 females studying in colleges and University of Karachi from April to August 2007 using a prescribed questionnaire. Among 1,407 female students who were interviewed for the study, 232 [16.48%] were not aware about tetanus immunisation program for females of reproductive age. Only 560 students [39.80%] received at least 1 of 5 recommended doses. Only 41 female students [2.91%] received complete course of 5 doses. Coverage of tetanus immunisation among literate females in most populous city of the country is far behind satisfactory. There is need for awareness and crash programs of tetanus immunisation

Acid aspiration prophylaxis during anaesthesia for caesarean section: a survey among anaesthetists at Hyderabad

Pulmonary aspiration of gastric contents leading to acid aspiration syndrome [AAS] is a well recognized risk factor during general anaesthesia [GA] for Caesarean section [CS]. The cross sectional observational study was conducted during July 2008 to October 2008 at Department of Anaesthesiology and Intensive Care, Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan. The objective was to assess anaesthetic practice patterns and measures to prevent aspiration of acid gastric contents in full term pregnant women undergoing anaesthesia for Caesarean section. A structured questionnaire regarding practice of anaesthesia for Caesarean section was distributed among anaesthetists working and practicing at Hyderabad. Results from the completed questionnaires were transferred to a Microsoft Excel spreadsheet and the responses represented as percentages. General anaesthesia was preferred by 75.4% anaesthetists for caesarean section, 83.6% anaesthetists used rapid sequence induction with cricoid pressure during general anaesthesia, 29.5% respondents restricted clear fluids for 2-3 hours. Antacids were used by 90% of the anaesthetists, while about 50% anaesthetists performed extubation when patients were fully awake. Recommended practice patterns and measures to prevent aspiration of acid gastric contents during anaesthesia for caesarean section are not observed by most of the anaesthetists working at Hyderabad

Teaching of anatomy in an integrated teaching based curriculum at the University Science Malaysia

The School of Medical Sciences of University Science Malaysia is the pioneer university in Malaysia who introduced the curriculum based ob Problem Based Learning [PBL]. The basic education strategy practiced by School of Medical Sciences is based on student oriented, problem based, integrated, community oriented, elective and self learning [SPICES]. Knowledge of anatomy is the foundation of effective clinical practice so anatomy is presented with appropriate changes during all phases of MD curriculum. Anatomy department is furnished with more than sufficient resource materials but anatomy museum has a unique role to play in integrated based teaching curriculum. Anatomy museum has been arranged on the basis of different modules or systems having plastinated, prosected specimens, video cassettes, models, MRI films, radiographs, ultrasound reports and teaching microscope. For structured living anatomy sessions in the clinical professional skill programmes, a fully equipped clinical skill laboratory is playing a vital role in integrated teaching curriculum of University Science Malaysia

Evaluation of anti tuberculous antibodies in healthy contact and non contacts persons

This study was conducted to see the presence of the antimycobacterial antibodies in healthy household contacts of tuberculous patients and healthy normal subjects who have never been in contact with tuberculous patients. A total of 200 subjects, 120 with history of household contact and 80 without such history were included in the study. Routine Haematological investigations were performed and all the sera of 200 subjects were tested for IgM, IgG and IgA anti tuberculous antibodies using ELISA technique. There was no difference in the average age of the household contacts and non-contacts. The complaints of pyrexia, night sweats and loss of weight was more in house hold contacts as compared to non-contacts. The awareness about BCG vaccination was equal among the household contacts and non-contacts. The combined serological positivity of the household contacts was 65.8% and the combined serological positivity for non-contacts was 34.1%. There was no statistically significant difference in the presence of I gM among household contacts as compared to non-contacts. However both IgG and IgA were present in significantly higher number of household contacts as compared to non-contacts. This study concludes that the persons living in the house with a patient suffering from active pulmonary tuberculosis [household contact] have more chances of being infected with Mycobacterium tuberculosis as compared to the healthy non-contacts

Posterior intercostal arteries in human cadavers; incidence of arch like anastomotic vessels

Objective: To find out the occurrence and frequency of variant anastomotic vessels at varying levels in Pakistani cadavers. Design: Twenty well preserved and freshly embalmed cadavers were dissected for the present study

Place and Duration of Study: The study was conducted during year 1995 - 1997 in the department of Anatomy, K.E. Medical College, Lahore

Methods: After cutting the ribs, anastomotic vessels between intercostal arteries were dissected free with the help of magnifying glass. The diameter of each arcade like anastomotic vessel was noted with the help of vernier caliper

Results: Arch like communications were found between neibouring inter- costal arteries V - VIII in ten and between intercostal arteries IV - X in six cadavers. In four cadavers, no anastomosis was found between intercostal arteries. The arch like anastomoses were found lying on the surface of the vertebral bodies on the right side and away from aorta on the left side

Conclusion: The results are comparable with the studies conducted previously with the exception of absence of such anastomotic vessels in four cadavers in the present study. It may be due to racial variation. So the arcades are the rule rather than variant is strengthened and confirmed

Incidence of an articular facet on conoid tubercle of adult Pakistani clavicles

Presence of an articular facet on the conoid tubercle of clavicles the existence of coracoclavicular joint. Among 450 Pakistani adult clavicles examined, facet was found present in 52 [11.5%] male and in only 1 [8.3%] female clavicle comparable to the previous observations in Asian 10.1% in males and 8.3% in females clavicles. The most common shape of the facet noticed was oval. Double circular facets were seen in only one left clavicle. The average size of facet measured was 10 x 6 millimeters

interosseous and lumbrical muscles of the human foot with special reference to their distal attachments

Pedal muscles play a vital role in posture maintenance and locomotion is human beings. There is a great controversy on the insertion of interossei and lumbrical muscles of the human foot in the literature. 112 lower limbs were dissected to observe the abnormal distal attachments of interossei and lumbricales. Anomalous insertions of planter interossei were observed in 11 [9.8%] limbs, of dorsal interossei in 12[10.7%] limbs, of lumbrical muscles in 24 [21.4%] limbs. Each of these muscles were found absent in 2 [1.8%] limbs. Anomalous distal attachments of interossei and lumbricales may be the part of evolutionary process of human beings which may or may not hinder the normal human locomotion

Hair distribution on the phalanges of the hand among Punjabis in Pakistan

Data on the frequency and patterns of hair distribution on the hand are available from different parts of the world. The present study was undertaken to document the findings from Pakistan. A random sample of 500 male and 548 female medical students aged between 18-25 years of Punjab province studying in King Edward Medical College Lahore, were examined. All the cases considered in this study had Punjabi parents. It was interesting to note that absence of hair on proximal phalanges, a rare finding in Nigerians [4% in males and 5% in females] was comparable to Pakistani population [2% males and 20% In females]. Incidence of absence of hair in proximal phalanges was highest in Pakistani Punjabi females. the incidence of absence of middle phalangeal hair in Pakistani population was found very high [75.2% in males and 81.2% in females was compared to Turks and other populations. Hair were not observed on distal phalanges in this study as reported by other workers. The frequency order of presence of hair on proximal phalanx in Pakistani population was found to be 3>4>2>5 and on middle phalanx it was 5>4>3>2> which differs from 4>3>5>2> as reported in other populations. Frequency of phalangeal hair In Pakistani population [21.7%] lies in between lowest found in Africans [21%] and highest found in Europeans [70%]

Incidence of inter frontal or metopic suture in the crania of adults

Variations of the metopic sutures have been mentioned by various workers in the past with some agreement over dates of closure, racial variations, their persistence, whether partial or complete. This study was carried out to find out incidence, pattern and shapes of metopic sutures in Pakistani people as no such data is available in our country. Two hundred and twenty six well preserved adult skulls from Punjab Province were examined for presence and patterns of metopic sutures. Complete metopic suture was found in 1.32% cases while incomplete metopic suture was observed in 76.7% cases. It was found absent in 23% cases. The incidence of extent of metopic suture in our study was found significanlty heigher than that reported by other workers. Incomplete sutues showed variations in shape. Inverted and radiating types were not observed in this study. We found an inverted 1G shaped suture in 90% of the skulls. This type has not been mentioned before by any worker

Anomalous pattern of insertion in interossei and lumbrical's hands

Anomalous patterns in comparison to those described in standard anatomical text, books about distal insertion of interossei and lumbricul muscles in the hand among 112 freshly embalmed upper limbs from both sexes were investigated during dissection in the Department of Anatomy, King Edward Medical College. Maximum anomalies were observed in the distal insertions of palmar interossei [65.2%] as compared to dorsal interossei [19.8%] and lumbricals [9.8]. Among palmar interossei, higher number of anomalous attachements were found in 1st, and 4th interosseous muscles

Position of the mental foramen: a comparison between Pakistani and other ethnic racial groups

One hundred and six adult mandibles [86 males and 21 females] were examined for foraminal position. In Pakistani males, the foramen lay between 1st and 2nd premolar on right side and in line with the root of 2nd premolar on left side. In females, it lay between 1st and 2nd premolars on both sides. As a whole modal position lies in line with the 2nd Premolar in Pakistani population. 6th position, a rare racial character was noted, lying in line with the root of Ist molar. The results of present study disagree with the notion that mental foramen always lies between 1st and 2nd premolars as described in anatomy text books

Variations in the structure of the jugular forament in Pakistani human skulls

one Hundred and two well preserved adult human skulls from both sexes were studied to examine the jugular foramen with respect to shape, presence of a domed bony roof, bony septation and various openings. Length, width and height of domed bony roof were measured with a vernier caliper. The incidence of larger left jugular foramen was higher while that of right jugular foramen was found slightly lower than Nigerian and Anatolian skulls[2]. Presence of a domed bony roof shows a large difference in percentage between Pakistani and other skulls on right and left jugular foramina. Absent jugular foramen was observed on right side in two skulls and left side in one skull which is not mentioned in the text books. They were replaced by 1-3 small foramina. Height of jugular bulb was found more in 49% on right side and 21.5% cases on left side. There is a considerable difference in the structure of jugular foramina of Nigerian, Anatolian and Pakistani skulls which suggests that this could be due to racial difference

rare human cranium showing maximum classical epigenetic variants

one hundred and fifty Skulls were examined for 32 classical Epigenetic variants listed in Gray's Anatomy 36th edition. Three or four variants were found in each skull. It was however, noted that 19 out of 32 classical variants were present in one skuII along with two more additional variants [i.e. Occipito - Mastoid ossuturale and paramastoid foramen] which are not mentioned in anatomical texts

Zinc citrate and spermatogenesis

Zinc citrate was given orally to 40 animals for two months in various doses to study the changes in the testes. It resulted in a gain in weight of the animals, which was statistically significant. Although no change was obsemed on gross examination of the testes but the histological evaluation revealed that spemtatogenesis was increased significantly, especially with megadosess of zinc citrate

Gross and histological changes in the mammalian skin after garlic treatment

Crude extract of garlic was applied daily with a soft brush on the shaved outer surface of ears and gluteal skin of forty eight adult albino rabbits. They were divided into two groups comprising of 36 experimental and 12 control animals. Half of the animals, both experimental and control, were sacrificed after 15 days of treatment whereas rest of the animals were kept for another month without treatment and then sacrificed to see the delayed effects. The tissues were processed, sectioned and stained by four different stains. The epidermis was thickened and showed hyperkeratosis, acanthosis, epidermal microabscess formation while dermis showed oedema, disturbed collagen fibres, increased vascularity; decrease in hair follicles, sweat glands, sebaceous gland and presence of inflammatory cells. The changes in the skin persisted to some extent even after discontinuation of treatment for one month