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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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This study was carried out to know the frequency and magnitude of different breast diseases including all the benign, malignant and inflammatory lesions in the local population of Bahawalpur in south Punjab, Pakistan. Descriptive cross-sectional study design. This study was conducted at the Department of Pathology, Quaid-e-Azam Medical College/Bahawal Victoria Hospital, Bahawalpur, Pakistan from January 2004 to December 2006. A retrospective data analysis of breast biopsies and mastectomies based upon histopathology. Histopathological analysis revealed that out 166 cases, 50% were benign, 37.34 % were malignant and12.65 % were inflammatory lesions; mean age of diagnosis was 33.2, 49 and 31.75 years for these lesions respectively. Of all the breast lesions, fibroadenoma was the most common 39.15 % [65 patients], followed by invasive ductal carcinoma 33.73 % [56 patients]. Non proliferative breast changes [fibrocystic changes 4.81 % and adenosis 3.01%] ranked third with 13 patients, while chronic mastitis and breast abscess were the fourth [5.42 %] and fifth [3.61%] common diagnoses respectively. Mean age of diagnosis for fibroadenoma and invasive ductal carcinoma was 21 and 48 years respectively. Fibroadenoma was the most common histopathological diagnosis while invasive ductal carcinoma was the most common malignancy of breast as well as the second most common diagnosis. Mean age of diagnosis for breast carcinoma was 49 years
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Humans , Female , Adult , Middle Aged , Breast Neoplasms , Cross-Sectional Studies , Retrospective Studies , Mastitis , Breast/pathologyABSTRACT
The present study was undertaken with the aim to detect bacteria and fungi as aetiological agent in CSOM and to see susceptibility pattern of bacterial isolates to different antibiotics and to determine the beta lactamase production by the bacterial isolates. Experimental Study. This study was conducted in the department of Microbiology, Basic Medical Sciences Institute, JPMC, Karachi, during the period of August 1998 to February 1999. During this period, 110 patients were seen, of them 62 were male and 48 were female with male to female ratio of 1.3:1. Two swabs were taken from each patients ear, one was put immediately in to Brain Heart Infusion [BHI] broth and the other was inoculated on Sabouraud Dextrose Agar [SDA] slant. BHI was incubated for 2-4 hours and subcultured on blood agar, chocolate agar and MacConkey's agar plates. The Chocolate agar was incubated in 5-10% CO[2] atmosphere in a candle jar and they were incubated for 24 hours at 37°C. SDA slant was incubated for 14 days at 37°C. Isolates were identified by Gram staining and then confirmed by biochemical test. Fungus growth was stained in Lactophenol Cotton blue [LPCB] and identified microscopically. Amongst bacterial isolates gram negative rods [41] and Pseudomonas aeruginosa [45] were predominant. 47 gram positive cocci were seen, of those 37 were Staphylococcus aureus. Fourteen fungal isolates were recovered, all of them were found to be Aspergillus species. Bacterial isolates were tested for beta-lactamase production the drug sensitivity was noted by disc diffusion method on Mueller Hinton agar. Ciprofloxacin and Enoxacin emerged as the most effective antibiotics. Tobramycin also showed good results against gram negative rods and Pseudomonas aeruginosa. Chloramphenicol, Clarithromycin and Minocycline showed good results against Staphylococcus aureus. And other gram positive cocci. Drug sensitivity of the fungi was not done. Micro-organisms showed least sensitivity to Ampicillin and Cotrimoxazole. It is concluded that to achieve the maximum benefits of antibiotics, we must use them with discrimination and with the understanding of microbial population and with the knowledge of their indications and limitations. The indiscriminate, haphazard and halfhearted use of antibiotics and poor follow up of patients causes more harm than good
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Experimental study. This study was conducted at various hospitals of Quetta. This study includes 103 cases of chronic granulomatous lymphadenitis, with 101 cases of tuberculosis lymph nodes amongst a total of 200 cases of non-neoplastic lymphadenopathy.Their ages ranged from 2 to 79 years. Maximum number of cases were in 10-29 years age group. Females [69.31%] were affected more as compared to males. The commonest presenting symptom was fever. Cervical lymph nodes [83 cases] were the commonest site of involvement whereas 18 cases showed multiple site involvement. Fluorescent staining of histopatholigical sections from 103 chronic granulomatous lymphadenitis gave positive results in 76 out of 103 [73.78%] cases, however Ziehl-Neelsen staining was positive only in 29 out of 103 [28.15%] cases. The yield of mycobacteria on fluorescent staining was higly significant [p<0.00l] as compared to Ziehl-Neelsen staining thereby providing the superiority of fluorescent stain. In a total of 200 cases of non-neoplastic lymphadenopathy 101 cases showed granulomatous lesions, histologically consistant with tuberculosis. Other causes of lymphadnopathy were chronic non-specific lymphadenitis [n=87] viral lymphadenitis [n=8], fungal lymphadenitis [n=2] and acute bacterial lymphadenitis [n=2]. Fluorescent staining of histopathological sections from 103 chronic granulomatous lymphadenitis gave positive results in 76 out of 103 [73.78%] cases, however Ziehl-Neelsen staining was positive only in 29 out of 103 [28.15%] cases. In 101 cases, the finding were consistent with the diagnosis of tuberculous lymphadenopathy. In our study, significantly greater number of cases, 78 out of 101 [P<0.001] diagnosed as tuberculous lymphadenitis were in age groups 10-29 years. Female [69.31%] were more affected than males [30.69%]. The common presenting symptom was fever. Cervical lymph nodes were commonest site of biopsy. Haemoglobin estimation in 98 cases revealed anaemia in 65 out of 101 [66.32%] patients of tuberculous lymphadenopathy. Erythrocyte sedimentation rate was performed in 63 cases and was raised in 52 [82.53%] cases. In a total of 80 cases in whom X-ray chest was performed, 14 [15.5%] cases revealed foci of tuberculosis. Thus, in conclusion, this study has highlighted the superiorty of fluorescent stain over ZN stain
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Humans , Male , Female , Benzophenoneidum , Rhodamines , Tuberculosis, Lymph Node/diagnosis , Lymphadenitis , Chronic Disease , Lymphatic DiseasesABSTRACT
A total 238 lymph nod specimen were studied at various Hospitals of Lahore. The ages of these patients ranged from 2 years to 80 years. Maximum number of patients with lymphadenopathy [90 out of 238] 37.8% cases were in 10-19 years age group. Females [51.7%] presenting with lymph node enlargement were more affected than males [48.3%]. The commonest presenting complaint was fever [56.3%]. Cervical lymph nodes [80.3%] were the commonest site of involvement. On histopathological examination, seven morphological groups were highlighted; tuberculous lymphadenitis [42.5%], chronic nonspecific lymhadenitis [36.6%], viral lymphadenitis [3.4%] acute bacterial lymphadenitis [0.8%]. Fungal lymphadenitis [0.8%], Metastatic carcinoma [11.3%] and lymphomas [4.6%]
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Humans , Male , Female , Middle Aged , Aged , Child, Preschool , Child , Adolescent , Adult , Lymphatic Diseases/pathology , Biopsy , Age Distribution , Lymphadenitis/epidemiology , Lymphadenitis/microbiology , Lymphoma/epidemiologyABSTRACT
To investigate the level of empowerment of women in accordance with human rights. A cross-sectional study. Residence Colony of Punjab Medical College, Faisalabad. Period: August-September 2007. There were 600 houses and 6 Blocks A, B, C, D, E and F in the colony. By Simple random sampling 10 houses were taken from each Block by drawing lots. Sixty married womens between the age of 25 -45 years [One from each house] were interviewed using a pre-tested structured questionnaire. The mean age of the respondents was 37.2 years. Among the total 60 [100%] women, 16 [26.6%] were illiterate, while 44 [73.3%] had primary education and above. Only 10 [22.2%] out of 44 educated women had graduate and above degree. Thirty-eight [63.3%] women had the opportunity to use the reproductive health services and family planning, while 22 [36.6%] could not utilize the family planning methods. A total of 40 [66.6%] women had good nutritional status, while 20 [33.3%] had imbalances in nutrition. Nineteen [31.6%] women were doing jobs in different public and private institutions, while 41[68.3%] had not got opportunity for jobs. Thirty-three [55%] women had monthly income less than Rs.10,000/- per month and 27[45%] had Rs.10,000/- and above. Forty [66.6%] women were given importance and active participation in decision making, in children marriages, house-hold and in political process [vote casting] at all levels, while 20[33.3%] were not given importance in decision making of above matters. Forty -three [71.6%] woman were given their right of inheritance / property. Fourteen [23.3%] women were forced to wear veil while going out of house. Forty [66.6%] woman admitted to have suffered from violence either psychological, physical or sexual in their life. Safe drinking water supply was available to 30 [50%] women, however sewage disposal, toilet facilities with in house were available to majority of the respondents. Atotal of 40 [66.6%] women were over all empowered. Women do have human rights as well. The results obtained from this study are encouraging but not up to the standards of International Human rights Principles, which are universal, inalienable; indivisible; interdependent and interrelated
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Humans , Female , Human Rights , Violence , Cross-Sectional Studies , Sampling Studies , Random Allocation , Family Planning Services , Reproductive Health Services , Decision Making , Surveys and QuestionnairesABSTRACT
The Clinico Morphological Changes in 150 Cases of Non-neoplastic lymph adenopathy were studied at BMC Complex Hospital Quetta. The ages of these patients ranged from 2 years to 80 years. Maximum number of patients with lymphadenopathy [65 out of 150] 43.3% cases were in 11-20 years ago group. Females [56%] presenting with lymph node enlargement were more affected than males [44%]. The commonest presenting complaint was fever [67%]. Cervical lymph nodes [82.6%] were the commonest site of involvement. On histopathological examination, four morphological groups were highlighted; tuberculous lymphadenitis [50%], chronic non-specific lymhadenitis [44%], viral lymphadenitis [4%] acute bacterial lymphadenitis [2%]. The study also highlights the yield of Mycobacteria on fluorescent staining as highly significant [P<0.001] as compared to Ziehl-Neelsen staining, there by proving the superiority of fluorescent stain
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Humans , Male , Female , Lymphatic Diseases/pathology , Tuberculosis, Lymph Node/pathology , Fever , Staining and Labeling , Cat-Scratch Disease , Toxoplasmosis , Sarcoidosis , ImmunohistochemistryABSTRACT
To find the effect of diabetes mellitus on the development of Chronic renal failure [CRF]. Descriptive Cross-sectional study. Allied Hospital, Faisalabad. From May 2008 to June 2008. Forty-Five patients of CRF were selected for study by convenient method technique from admitted patients in dialysis unit of Allied Hospital Faisalabad. In our study, out of 45 patients of CRF, 25 [55.6%] were found to be diabetic. The effect of diabetes on the development CRF was highest in age group of 71-85 years that was 100%. In this study diabetes mellitus was found to be more prevalent among married CRF patients [62%] as compared to unmarried patients among whom it was [17%]. Among the male CRF patients 54% were diabetic, while among the female CRF patients 57% were diabetic. Percentage of CAF patients having diabetes mellitus was 55.6%. From the above results it is concluded that effect of diabetes mellitus on the development of CRF increases with age. Diabetes mellitus was found to be more prevalent among female CRF patients and also among the married CRF patients. The development of Chronic renal failure can be prevented by early diagnosis and treatment of diabetes mellitus
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Humans , Male , Female , Kidney Failure, Chronic/epidemiology , Diabetes Mellitus , Diabetes Complications/prevention & control , Diabetic Nephropathies/prevention & control , Cross-Sectional Studies , Risk FactorsABSTRACT
To compare the outcome of MAGPI and Mathieu Procedures in the treatment of distal penile hypospadias in children. Material and This prospective comparative study was conducted in the Department of Paediatric surgery Lady Reading Hospital, Peshawar from Jan 2002 to Dec 2002. A total of 40 children with distal hypospadias without chordae were selected. They were divided into two groups. Group one consisted of 20 children with glandular, coronal and subcoronal hypospadias without a groove in the glans penis. For this group MAGPI procedure was performed. Group two consisted of 20 children with coronal and subcoronal hypospadias with a groove in the glans penis. This group was managed with Mathieu procedure. of the two procedures were compared. Age of these boys ranged from one to 10 years. 32 children had coronal and subcoronal hypospadias while 8 had glandular hypospadias. Functional and cosmetic were good in Mathieu procedure but the fistula rate was more as compared to MAGPI procedure. Meatal stenosis was more commonly observed in MAGPI procedure. Observed P valve of 0.02 between two procedure is significant statistically. The MAGPI procedure was found to have better as the fistula rate was significantly less in spite of the frequent meatal stenosis