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Objective: Cervical carcinoma is one of the most common diseases in our setup studies show that it is preceded by precursor lesions. It has been suggested that persistent infections with human papillomavirus (HPV) is the major risk factor in the development of this invasive cervical neoplasia. The rationale of this study was, whether detection may contribute to the identification as a major risk factor in cervical neoplastic lesions. Study Design: Experimental study. Methods: 102 cases were selected after screening 1000 specimens through Papanicolaou stains of cervical cytology and histopathology for detection of HPV and its subtype PCR. Data for risk factors were collected by a questionnaire and association of HPV was seen with Positive PCR results. Patient demographics including their age, sexual partners, marital status, socioeconomic condition, contraceptive and screening history were evaluated to determine whether subsidiary risk factors are associated with HPV and the development of cervical lesions among Pakistani women. Major Outcome: 85% cases of cervical carcinoma were associated with high risk HPV infection. Results:46/102 (45%) cases were low grade squamous cell intraepithelial lesions(L-SILs),twenty two (21.5%) cases were high grade squamous cell intraepithelial lesions (H-SILs), 14(13.7%) cases were squamous cell carcinomas(SCC), 6 (5.8%) cases showed features of adenocarcinoma, 10(9.8%) cases showed cytology of atypical squamous cells of undetermined significance(ASCUS) and 4(3.9%) cases were of atypical glandular cells of undetermined significance(AGUS). Out of 102 cases, 88/102(86.27%) were positive for HPV and among them 32/88 (36%) cases were of HPV-16 and 56/88(64%) cases of HPV-18. There was strong association of HPV positivity with young age, early marriages, poor socioeconomic condition, abortions, multiparity and smoking but there was no association with multiple marriages. Conclusion: Frequency of HPV-18 was greater than HPV-16 in cervical neoplastic lesions and was strongly associated with certain known risk factors for cervical carcinoma.
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Objective:To identify the differential expression of candidate gluconeogenic genes which may initiate hepatitis C virus (HCV) related metabolic disorder during early stages of disease. Methods:Patients of diverse age and sex, with positive HCV genotype 3 (HCV-3) RNA in serum and with no history of other related infections, co-infections, alcoholism, diabetes or chemotherapeutic treatments were considered for this study. Semi-quantitative reverse transcriptase PCR analysis and quantitative fold change analysis of the fresh liver biopsies of eight chronically infected HCV-3 patients and six healthy individuals were evaluated for three potential biomarkers involved in glucose homeostasis induction, namely mitochondrial phosphoenolpyruvate carboxykinase 2 (PCK2), glucose-6-phosphatase catalytic subunit (G6PC) and associated forkhead box protein 01 (FOXO1).Results:Symptomatic evaluation, clinical history and blood test were conducted according to general disease prognosis procedures and reported here. Significantly upregulated expression ofPCK2 independent of age, sex and viral infectivity levels in all HCV patients was observed, whereas no significant changes in the expression ofG6PC andFOXO1were found.Conclusions:PCK2 triggers initial gluconeogenic reactions which ultimately result in the accumulation of glycogen in the liver hepatocytes. We therefore suggest that the overproduction of PCK2 has important physiological role in the onset of metabolic disorder in the HCV-3 patients.
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Background: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections are major health problems associated with blood transfusion practices in Pakistan. This study was conducted on a large population to asses the epidemiology of HCV and HIV in the North West Frontier Province (N.W.F.P) of Pakistan Methods: Between January 2008 and July 2009, 62,251 healthy blood donors (BDs), aged 17-50, were included. In that group, 61,059 (98.1%) were male and 1192 (1.9%) were female. All donors from the 11 areas of N.W.F.P were screened for HCV and HIV antibodies by ELISA (Biokit). Blood groups were also determined. Results: HCV prevalence was 2.6% while HIV infection was 0.045% in this Pakistani population. Prevalence of HCV and HIV in 2008 was 2.4% and 0.049% respectively. In 2009, it was 3.0% for HCV and 0.038 for HIV. Among the age groups, the prevalence of HCV and HIV was not significantly different (p=0.128). Only 1484 (2.4%) of the donors were voluntary, the remaining were paid and family blood donors. The difference in the number of male and female donors was highly significant (p=0.00001). The B+ blood group was found in 30.5% followed by O+ in 25.9%, A+ in 24.9%, AB+ in 10.4%, A- in 2.6%, B- in 2.5%, O- in 2.3%, and AB- in 0.9%. Our study revealed a higher prevalence of HIV than in most of previous reports. Conclusion: The frequency of HCV infection in blood donors is higher in N.W.F.P than in most of the rest of the world and lower than in other regions of Pakistan. Transfusion of infected blood is a common cause of transmission. HIV prevalence is increasing in Pakistan.
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Hepatitis B virus prevalence is increasing in Pakistani population. National level estimates regarding the prevalence are missing. People are unaware of the risk factors involved in HBV transmission. The objective of the study was to review the prevalence, genotypes, and risk factors associated with HBV transmission in Pakistani Population. Literature search was done by using keyword HBV prevalence, genotypes and risk factors from Pakistani population at Pubmed, PakMediNet and Google scholar. Six different studies showed that the percentage prevalence of HBV in general population was 4.61±0.73%, and 21 different studies showed the percentage prevalence of 2.33±0.46% in blood donors. High prevalence of 7.94±1.49% and 12.86±4.52% were observed in multi transfused and IDU populations. Six different studies showed that the major prevalent genotype was D. Awareness regarding various risk factors involved in-viral transmission was very low. Prevalence of HBV was very high in multitransfused populations due to non-implementations of international standards regarding blood transfusions. Barbers were unaware of the risk factors associated with their shops in viral transmission. Practices of unsterilized dental and surgical instruments and recycling of syringes were major factors in viral transmission. Massive awareness and vaccination programs are required to decrease the future burden of HBV from Pakistani population.
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Background: In Pakistan, most patients with Hepatitis B and C have history of facial and armpit shaving from barbers. Objective: Evaluate the awareness and risk factors associated with barbers in transmission of Hepatitis B and C. Subjects and methods: A cross sectional survey was conducted in Rawalpindi and Islamabad, the twin capital cities of Pakistan between January and July 2009. Five hundred and eight barbershops were surveyed. Results: Out of 508 barber shops, 99.8% and 98.2% were washing their razor with water and water plus antiseptic solution, respectively, while 99.8% were using new blades. Only 39.6% knew that hepatitis B virus (HBV) and hepatitis C virus (HCV) were viral diseases, 26.6% knew that it can lead to cancer, 90.7% thought that hepatitis could be transferred by blade sharing, 47.8% knew that a vaccine for HBV was available, and 43.0% had education beyond the primary level. None of the barbers used a new or washed apron/towel on every customer. Conclusion: In Pakistan, a small number of barbers are shaving clients with an old style razor with a permanent blade. There is moderate awareness about the various modes of transmission of hepatitis among the barbers, and most of them don’t know about vaccination. A predominant number of them are considering interferon treatment as a vaccine for hepatitis B and C.