Prevalence of gastrointestinal parasitic infection in cows and buffaloes in Lower Dir, Khyber Pakhtunkhwa, Pakistan

Abstract Gastrointestinal (GI) Parasitic infection is a hot issue for cattle management. There is variation of GI parasites effects in sex, age of cattle, drinking water condition, nutrition, and severity of infection. Studies on prevalence of GI parasites among cattle population in Dir Lower are lacking. A total of 40 farms were selected randomly in six tehsil namely Tehsil Adenzai, Tehsil Timergara, Tehsil Balambat, Tehsil Munda ,Tehsil Lalqala, Tehsil Khall. Freshly cattle fecal samples were collected randomly from the selected farms during March 2018 till December 2018. Out of 314 buffaloes and cattle examined 58.59% (184/314) were positive for eggs, cyst/oocyst of one or more species of GI Parasites. The prevalence of parasitic infection was higher in Buffaloes 63.55% (75/118) as compared to Cow 55.61% (109/196) but the difference was not significant (p>0.05) Entamoeba,spp, Moniezia spp, Haemonchus spp and Coccidian spp were found in this study. The non-treated animals indicated the highest percentage of infection in cow 57.71% (101/175) and buffalo 68.13% (62/91).GI parasite prevalence in female animal were higher female cow 62.58% (87/139) and female buffalo 77.33% (58/75) as compared to male. But the difference is non-significant (p> 0.05) Yearling calves had the lower rate of GI parasitic infection than adults. Future investigations are necessary to evaluate the economic loss due to GI parasites in cattles.

Resumo A infecção gastrointestinal (GI) parasitária é um assunto importante para o manejo do gado. Existem variações nos efeitos dos parasitas GI quanto a sexo, idade do gado, condição da água potável, nutrição e gravidade da infecção. Faltam estudos sobre a prevalência de parasitas GI entre a população de gado em Lower Dir. Um total de 40 fazendas foi selecionado aleatoriamente em seis tehsil, nomeadamente Tehsil Adenzai, Tehsil Timergara, Tehsil Balambat, Tehsil Munda, Tehsil Lalqala, Tehsil Khall. Amostras fecais de gado fresco foram coletadas aleatoriamente das fazendas selecionadas de março de 2018 até dezembro de 2018. Dos 314 búfalos e bovinos examinados, 58,59% (184/314) foram positivos para ovos, cisto/oocisto de uma ou mais espécies de parasitas GI. A prevalência de infecção parasitária foi maior em Buffaloes 63,55% (75/118) em comparação com vaca 55,61% (109/196), mas a diferença não foi significativa (p > 0,05). Entamoeba spp, Moniezia spp, Haemonchus spp e Coccidian spp foram encontrados neste estudo. Os animais não tratados indicaram a maior porcentagem de infecção em vacas 57,71% (101/175) e búfalos 68,13% (62/91). A prevalência do parasita GI em fêmeas foi maior em vacas fêmeas 62,58% (87/139) e búfalas 77,33% (58/75) em comparação ao masculino. Mas a diferença não é significativa (p > 0,05). A modelagem linear geral mostrou que o tratamento do animal estava significativamente relacionado com a prevalência de parasitas GI. Bezerros de um ano tiveram a maior taxa de infecção parasitária gastrointestinal. Futuras investigações são necessárias para avaliar a perda econômica devido aos parasitas GI em bovinos.

Nephroprotective property of Cinnamomum zeylanicum and its antibacterial activity in combination with gantamicin

Cinnamomum zeylanicum has strong antioxidant properties and has been presented to have nephroprotective effects. Present work was aimed to study the nephroprotective property of the plant extract through urinary enzymes excretion, to confirm its protective effects and to observe the antibacterial activities of gentamicin in combination with the plant extract. 200mg/kg/day of the plant extracts were administered alone and as co-therapy with gentamicin. Urinary lactate dehydrogenase [LDH] and Urinary alkaline phospatase [ALP] excretions were observed through reagents kits with the help of Power-Lab 300. Antibacterial activities were assessed for gentamicin alone and in combination with the extract. Present study showed that the plant extract have excess quantity of flavonoids, which may responsible for attenuating the excessive excretion of urinary LDH. However, Urinary ALP excretion was found remained same throughout the study period in all experimental groups; might be detected in acute damage. Further, the plant also proved to have no decreasing impact on the antibacterial activities of gentamicin

relationship between developmental dysplasia of hip and mode of delivery in term-breech-neonate

To investigate the relationship between developmental dysplasia of the hip and mode of delivery in term breech neonates. Prospective Cohort Study. This study was conducted in Khyber Teaching Hospital Peshawar from May 2012 to April 2013. Over the study period all neonates delivered at term as singleton breech in the Obstetrics and Gynecology department of Khyber Teaching Hospital were included in the study. Period of gestation, parity, and mode of delivery, fetal gender and birth weight of each neonate was recorded. All neonates were assessed for DDH both clinically and through ultrasound. Severity of dysplasia was graded using modified Graf's static morphological method. Correlation was made between DDH and mode of delivery. Mode of delivery was categorized as vaginal delivery, emergency cesarean section and elective cesarean section. There were a total of 283 breech deliveries during the study period, out of which 16 had DDH. Incidence was more in primigravidae. Majority were females. DDH was more common in vaginally delivered breech babies, in majority of whom DDH was more severe [Graf type III and IV, as opposed to babies delivered through elective cesarean section. Vaginally delivered breech babies constitute a high risk group for DDH. Clinical examination followed by ultrasound examination of both hip joints should be undertaken in all babies delivered as breech so as to institute management in time to prevent avascular necrosis of femoral head

Non operative treatment; functional outcome of radius ulna diaphyseal fractures in children

Pediatric forearm fractures result in substantial morbidity and costs. Despite the success of public health efforts in the prevention of other injuries, the incidence of pediatric forearm fractures is increasing. Most forearm fractures occurred during the spring season. Objective of the study is to determine the functional outcome of conservatively treated radius ulna fractures in Children. Descriptive study. Department of Orthopedics and Traumatology, Khyber Teaching Hospital Peshawar. March 2009 to April 2010. Total 236 children with radius ulna fractures were manipulated and above elbow plaster Cast applied for 6-8 weeks and reviewed every second week. After plaster cast removal Pronation and supination measured with goniometer and fortnightly thereafter for 6 weeks. All the fractures united. Normal range of pronation and supination at the end of follows up period was in 182 [80.53%] children. Loss of pronation and supination of average 10 degrees were in 9[3.98%] patients. Patients having displacement of the fracture and opted for surgery were 35 [15.46%]. Closed reduction of diaphyseal fractures in children results in normal pronation and Supination in majority of the patients

Preliminary antioxidant profile of Pistacia integerrima Stewart

To explore the free radical scavenging properties of crude ethanolic extract of galls, bark, leaves, roots of Pistacia integerrima and its subsequent solvent fractions viz., n-hexane, chloroform, ethyl acetate and methanol against 1, 1-diphenyl-2-picrylhydrazyl [DPPH] stable. In vitro DPPH based free radical was employed using querceitin as standard antioxidant while methanol as negative control. Different parts of P. integerrima showed marked scavenging on DPPH in a concentration dependent manner. The ethanolic extract exhibited 60.51 88.51% scavenging effect on DPPH which differentiated upon fractionation. Of the part used, leaves of the plant were the least effective while n-hexane was the least dominant fraction. However, the rest of the parts and fractions demonstrated profound scavenging potential. This in-vitro study revealed an outstanding free radical scavenging potential of various solvent fractions of different parts of whole plant P. integerrima

Prevention of low backache in pregnancy

To document the effect of back care advice on the frequency and severity of low backache in pregnancy. Comparative cross sectional study. This study was conducted in Antenatal Outpatient department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar from Jan 2012 to Jun 2012. Advice on back care was made available to a group of primigravidae women as early in their pregnancy as possible. For comparison another group of primigravidae women for which no such advice was given was recruited. Both groups were followed throughout pregnancy for the occurrence of low back pain and its severity. The study comprised of 200 primigravidae with 100 women each in study group and control group. Seventy eight women in study group and 65 in the control group reached term. Among the study group 28.2 % experienced low backache in contrast to control group in which 56.9% developed back pain during pregnancy. In the study group 68.1% were having mild, 27.2 % moderate and only 4.5% severe pain. In the control group majority of women experienced moderate to severe pain. Furthermore the study group had pain much later in gestation as compared to control group. Low backache was less common inprimigravidae women who receive advice on back care early in pregnancy. Low back pain, if present was less troublesome and severe than pregnant women for whom no such advice was available

Risk factors and management of birth related femoral fracture

To evaluate the risk factors and management of femoral fractures related to birth trauma. , Descriptive Case series Study. This study was conducted in Department of Orthopaedics and Traumatologyand Department of Obstetrics and Gynecology of Khyber Teaching Hospital, Peshawar from April 2008 to March 2013. Over a period of 5 years,cases of femoral fractures in newborns due to birth trauma presenting to Orthopaedic and aumatologydepartment or occurring in Obstetrics and GynecologyDepartment of Khyber Teaching Hospital Peshawar were recruited to the study. Birth histories of the cases were explored with respect to period of gestation, birth weight, presentation at birth and mode of delivery.Type of fracture and management used was documented. Cases were followed till recovery. Mean gestational age was 38.1 weeks and mean time to diagnose was 3 days. Presentation of baby was breech and mode of delivery was Caesarean section in majority of cases.Mid shaft fracture was present in ten cases and three had subtrochanteric fracture. All patients showed complete union at a mean duration of 3.2 weeks. Femoral fracture due to birth trauma in newborn is a rare injury. It is more common in cases of Caesarean section done for breech presentation. Risk is high in preterm and/or low birth weight babies. Fracture mostly involves shaft of femur.These fractures have very good prognosis and show complete healing following immobilization

Acute septic arthritis: open drainage versus needle aspiration

This study aimsto compare the effectiveness of open drainage with needle aspiration in acute septic arthritis in our local population. Randomized controlled trial. This study was conducted in Orthopedics and Trauma unit, Khyber Teaching Hospital, Peshawar from Feb 2009 to Jan 2010. There a total of 114 patients that were randomly assigned to group A and B with 57 patients in each group. Group A was subjected to open drainage and Group B to needle aspiration. The effectiveness of intervention was assessed by the reduction of at least one grade of pain from the baseline on 7[th] post-operative day. In group A 26 [45.61%] and 31 [54.38%] patients had Grade 2 and Grade 3 pain respectively whereas in group B 28[49.12%] and 29[50.88%] patients had Grade 2 and Grade 3 pain respectively[p value 0.0025].Open drainage and needle aspiration in group A and B were effective in 49 [85.96%] and 39[68.42%] patients respectively [p value 0.0025]. Open drainage is more effective than needle aspiration in patients with acute septic arthritis

Birth related Erb's Palsy: obstetrical correlates and outcome

This study aims to determine the obstetrical correlates and outcome of birth related Erb's palsy. Retrospective cohort study. This study was conducted in Obstetrics and Gynecology and Orthopedics and Traumatology Departments of Khyber Teaching Hospital Peshawar from Dec 2004 to Nov 2009. Hospital records from Dec 2005 to Nov 2010 were searched. A cohort of all cases of birth related Erb's palsy over a 5 year period was recorded. Birth records of cases were obtained. Cases were contacted and called for followup and assessment of functional outcome from Jan through March 2013. a total of 30, 367 live births were recorded during the study period out of which there were 28 cases of obstetrical Erb's palsy. Their birth records revealed that 27 were delivered vaginally and only 1 through cesarean section. In 17 cases delivery was complicated by shoulder dystocia out of which 10 mothers were diabetic. Mean weight at birth was 3.8 kg. All cases were managed conservatively. Twenty five cases presented for follow up. Twenty cases had no residual functional deficit. Five children had some form of functional deficit present. Erb's palsy is seen more commonly in births complicated by shoulder dystocia and in diabetic mothers with high birth weight babieds. Conservative management is effective but regular follow up is needed to pick up those cases that require surgical intervention to prevent lifelong handicap

Prevalence of vitamin D inadequacy among postmenopausal women

To evaluate serum vitamin D levels and factors related to vitamin D inadequacy in postmenopausal women. Observational Cross-sectional study. This study was conducted in Outpatient departments of Obsetrics and Gynaecology and Orthopedics and Traumatology, Khyber Teaching Hospital, Peshawar from Dec 2011 to No 2012. During the study period, 200 postmenopausal women presenting to Orthopedics and Gynecology outpatient departments of Khyber Teaching Hospital were randomly recruited to the study. Women with active liver and/ or kidney disease and those taking drugs affecting calcium and vitamin D metabolism were excluded from the study. Serum Vitamin D levels were analyzed and were categorized as adequate [more than 30 ng/ml], insufficient [20-30 ng/ml], mild deficiency [10-20 ng/ml], moderate [5-10 ng/ml] and severe [<5 ng/ml]. The study included 200 postmenopausal women. Mean age was 58 years with a mean BMI of 24.3 kg/m[2]. Mean Vitamin D levels were 14.7 ng/ml with a range of 4-62 ng/ml. Vitamin D deficiency was present in 59% of postmenopausal women. Thirty three percent had mild deficiency while 21% had moderate deficiency. Five percent of women were severely deficient. More than half of postmenopausal women in our province have vitamin D deficiency underscoring the need for vitamin D supplementation in this vulnerable population. Prevention and early detection of hypovitaminosis D is the key to reduce the incidence of osteoporosis among postmenopausal women

Out patient medical management of anembryonic pregnancy using misoprostol

This study aims to evaluate the efficacy, safety and acceptability of misoprostol for outpatient management of anembryonic pregnancy. This was a prospective observational study. This study was conducted in the Department of Obstetrics and Gynaecology, Khyber Teaching Hospital Peshawar from Dec. 2011 to Nov. 2012. Over a study period of one year 100 women attending our unit with ultrasound proven anembryonic pregnancy of < 10 weeks' gestation and opting to have medical management and consented to have it on an outpatient basis were recruited for the study. All patients were given 800 micro g of misoprostol intra-vaginally in the unit and advised to take two further doses of 400 micro g of misoprostol, orally, 3 hours apart, the following day at home. Outcome measures included success rates, emergency admission rates, pain scores, satisfaction level, incidence rates of side - effects and number of women who would choose medical management in future. Of the 100 women with anembryonic pregnancy, over three - quarters [n = 88, 88%] of the women achieved successful complete medical evacuation. Overall 6 [6%] women presented for emergency admission. Eighty eight patients were satisfied with the management. The mean visual analogue scale [VAS] score of all women was 6.9. Eighty seven said that they would choose to have medical evacuation in a future miscarriage. A total of 85 women said they would prefer to have the treatment at home rather than in the hospital. No serious side effect was reported with misoprostol. It was concluded that medical evacuation of anembryonic pregnancy is effective, safe and acceptable in the outpatient setting

Effectiveness of platelete rich plasma [PRP] injections in patients with plantar fasciitis

To determine the effectiveness of PLATELETE RICH PLASMA [PRP] injection in patients with plantar fasciitis interms of improvement in at least one grade of pain on visual analogue scale at 6 weeks interval follow up. Descriptive cross sectional study. This study was conducted in Orthopedics Unit of Khyber Teaching Hospital, Peshawar from March, 2012 to Feb 2013. Patients with plantar fasciitis from the age of 20 to 50yearswho were not responding to oral medications were included in the study. There were 26 [9.38%] males and 38 [59.38%] females with mean age of 37.00 years. 45.31% patients have symptoms for 6-12 weeks where as those who had symptoms for 13-26 weeks made 48.43%of the study population. A total of 43[67.18%] patients having moderate pain before PRP only had severe pain at 6 weeks, while 25 [39.06%] had no pain, 13 [20.31%] had mild pain and 4 [6.25%] had moderate pain. Out of 21 [32.81%] patients who had severe pain before PRP, 36 [56.25%] had no pain, 18 [28.12%] had mild and 9 [14.06%] had moderate pain. Nonetheless, 3 [4.69%] had severe pain even after PRP. Over all, PRP was equally effective in patients of all ages and was more effective in men. Platelet Rich Plasma which is cheap and effective can successfully treat patients with plantar fasciitis

Conservative management of proximal fifth metatarsal fractures [Jones fracture]

To determine the outcome of proximal fifth metatarsal fracture treated by POP [Plaster of Paris] cast. Descriptive Cross -sectional study. This study was conducted in the Department of Orthopaedics and Traumatology of KhyberTeaching Hospital, Peshawar from Jan 2012 to Jan 2013. Hundred patients with fracture of proximal fifth metatarsal bone [Jones fracture] were managed conservatively with plaster cast immobilization. Fracture healing and functional outcome was assessed. The mean age of the patients was 53 years. The clinical and radiological union rates at 6 months of follow up were 97% and 95.3% respectively. A progressive improvement in AOFAS [American Orthopaedic Foot and Ankle Society] mid foot scale score was seen. Overall 92% patients were satisfied with theoutcome.Four patients had malunion and only one had nonunion. Acute fracture of proximal fifth metatarsal can be effectively managed by plaster cast immobilization

Carpal tunnel syndrome in pregnancy

To determine the frequency, severity and prognosis of carpal tunnel syndrome [CTS] in pregnancy. Descriptive Cross -sectional study Place and duration of Study: This study was conducted in Gynae [B] Unit of Khyber Teaching Hospital, Peshawar from Apr 2012 to Mar 2013. During the study period, pregnant women presenting to Antenatal Outpatient Department of Gynae B unit were randomly assessed for carpal tunnel syndrome. If present, severity of CTS and its relation to age, trimester of pregnancy, weight gain during pregnancy, parity and any underlying medical problem was made. Treatment was advised and response to treatment was assessed. Patients were followed up for outcome. Of 1000 Pregnant women assessed, 22.3% had symptoms and signs suggestive of CTS. Bilateral [68%] paresthesia [82%] and pain [60%] in third trimester of pregnancy were the most frequent presenting symptoms. It was more common in >30 years old mutigravidae and with a weight gain in pregnancy of more than 15kg. Majority [95%] of patients responded to splinting of wrist at night. Carpal tunnel syndrome is common during third trimester of pregnancy especially in mutigravidae who gain more weight during pregnancy and are above 30 years of age. CTS severe enough to warrant surgical treatment occurs infrequently in pregnancy and generally responds to conservative treatment

External fixation: daily versus weekly pin site care

To determine whether there were any differences in the frequency and severity of pin site infections by performing pin site care daily or once a week. cross sectional descriptive study. This study was carried out at Department of Orthopaedics and Traumatology, Khyber Teaching Hospital, Peshawar during the period from Dec 2011 to Jun 2013. This study included 96 patients who were selected by convenient [non probability] sampling technique. Patients were divided into two groups. The mean infection rate during the study in group 1 was grade I in 16% and grade II in 7%, grade III in 1% versus grade I in 12% and grade II in 5%, grade III in 5% in group 2. No grade IV-VI infections were noted. Antibiotics were prescribed for a mean of 60 days [SD 15] in group 1 and 45 days [SD 30] in group 2. The relative risk [RR] of positive cultures at the proximal pin sites was 1.5 [95% CI 1.2-1.9] No difference was found between the groups. No differences between daily and weekly pin site care were observed as regards the severity of infections, frequency of infection rate, of positive cultures, except in week 6, and in use of antibiotics or analgesics

Three monthly intravenous injections of ibandronate in the treatment of postmenopausal osteoporosis

Osteoporosis is a chronic condition that generally requires long-term therapy for fracture risk reduction to become apparent. Bisphosphonates are important therapeutics in postmenopausal Osteoporosis. However, they are currently associated with stringent dosing instructions that may impair patient compliance and hence therapeutic efficacy. Intravenous [IV] treatment with an aminobisphosphonate, pamidronate was effective, but required infusions. Ibandronate, a new very potent aminobisphosphonate, can be administered safely as an IV bolus injection, and therefore offers an interesting alternative suitable for outpatient treatment. To determine the effectiveness of three monthly IV boluslbandronate injections in terms of increase in bone mineral density at hip and spine in postmenopausal women. Randomized Placebo controlled study. This study was conducted in Gynae [B] Unit of Khyber Teaching Hospital, Peshawar from Feb 2012 to Jan 2013 150ambulatory Postmenopausal women 55-75 years old, and atleast 5years since menopause with Osteoporosis [[bone mineral density [BMD] < -2.5 SD T score] received a placebo or IbandronatelV bolus injection [3 mg] every 3 months. All patients received 1 g calcium/day. BMD, expressed in T score, was measured by dual-energy x-ray absorptiometry [DEXA] at lumbar spine and hip. Exclusion criteria were a disease, disorder, or therapy [within the last 6 months] known to influence bone metabolism; prior treatment with oral or intravenous bisphosphonates; Baseline radiographic assessment for prevalent vertebral fractures was not performed in this study. All participants provided written informed consent. There were 150 Postmenopausal women with mean age of 62 years.Lumbar spine BMD [L2 to L4] decreased by 2.9% and hip by 3.2% in the placebo group, but increased by 5.2% at 12 months for Ibandronategroup. The increase was statistically significantly different from placebo [P < 0.001] group. After 1 year total hip BMD increased significantly by 4.5%.Treatment of postmenopausal Osteoporosis by interval IV bolus injections of the bisphosphonate Ibandronateis an effective and convenient way of increasing BMD at hip and spine. The high potency of Ibandronate allows 3-month interval bolus IV injections as a new therapeutic approach with optimal compliance

Effectiveness of local corticosteroids in carpal tunnel syndrome

Carpal tunnel syndrome [CTS] is one of the most common entrapment peripheral neuropathy manifested by signs and symptoms of irritation of the median nerve at the level of the carpal tunnel in the wrist. Carpaltunnel syndrome has been treated by local corticosteroid injection but its effectiveness remains unknown in our set up. To assess the effectiveness of 40 mg methylprednisolone with 10 mg lignocaine injection proximal to the carpal tunnel in patients with the carpal tunnel syndrome. Descriptive Cross Sectional Study. This study was done at Department of Orthopaedics and Traumatology, Khyber Teaching Hospital, Peshawar from February, 2012 to February, 2013. This study comprised of 32 patients. Local steroid injection consisting of 10 mg lignocaine and 40 mg methyl prednisolone was injected at the volar aspect of the forearm close and proximal to the carpal tunnel. The effectiveness was determined in terms of decrease in at least one base line grade of pain and numbness at affected hand during 4 and 12 weeks follow up. There were 4 [12.50%] males and 28 [87.50%] females with mean age of male and female was 30.75 +/- 6.23 and 33.42 +/- 7.07 respectively. In patients with severe pain, the effectiveness was 90.90% and 100% at 4 and 12 weeks respectively. Among the patients with mild numbness, the success rate was 83.33% and 91.67% at 4 and 12 weeks respectively while in case of moderate numbness, the effectiveness was 100% at 4 and 12 weeks follow up in patients. A local single injection of steroids in carpal tunnel syndrome is effective in relieving pain and numbness in short terms

External fixator; functional outcome in open tibial fractures

Open Tibial shaft fractures are one of the most common fractures of long bones. External fixation is method of choice for the treatment of open tibial shaft fractures. The subcutaneous location of tibia makes it suitable for the application of external fixator. This study was done on 50 patients at Orthopaedics and Trauma unit "B" at Khyber Teaching Hospital, Peshawar, from Jan 2008 to Feb. 2009 to determine functional outcome of A.O. external fixator in open tibial fractures in terms of knee and ankle mobility, pain and gait on full body weight bearing. The data of all patients was entered in standardized proforma and analyzed on SPSS 10. There were 43 [86%] males and 7 [14%] females. There were 17 [34%] type-II and 20 [40%] type IIIA and 13 [26%] type III B fractures. Knee mobility was full [100%] in 49 [98%] cases, 75% in 1[2%]. 43 [86%] cases retained 100% ankle joint mobility while it was 75% in 4 [8%], 50% in 2 [4%] cases and 25% in 1[2%] cases. On full body weight bearing, 42[84%] patients were pain free, and moderate pain was in 4[8%] cases. In 42[84%] cases the gait was completely normal on full body weight bearing while 3[6%] cases showed significant limping. The excellent functional results in our series show that external fixation of tibia is safe and effective in terms of restoring functions of tibia

Prevalence of cancer in CENAR Quetta

Aims and Objectives: A retrospective study of allcancer registered cases at the Center for NuclearMedicine and Radiotherapy [CENAR] Quetta From1st Jan, 1998 to 31st December 2009[12 Years] wascarried out. CENAR Quetta is the only cancermanagement center in Balochistan. The aim of thisanalysis was to highlight the prevalence of Cancerin Balochistan

Study Design: A retrospectivestudy

Place and duration of Study: The study wasconducted at CENAR Quetta

Results: During thestudy period, 12022 cancer patients were registeredat CENAR and BMCH Quetta. Out of these 10924files of patients [91.19%] were analyzed. The datawere analyzed from various angles of prevalencee.g. total number of registered cancer patients, Sex,Age, Histopathology, Demographic profile etc

Conclusion: As cancer management is a globalchallenging health problem including Pakistan, sothe first step for all health program worldwide is tohighlight the prevalence, incidence and etiologicalfactors of the disease in the locality, for step wisegoing towards management and control

Uptake of Tc-99m MIBI for assessment of cold thyroid nodule

Presence of nodule in the thyroid is a common problem throughout the world, incidence of which varies from region to region. This study was designed to appraise the diagnostic strategy to differentiate between malignant and benign lesions in solitary cold thyroid nodules using technetium-99m MIBI scintigraphy. Forty-nine patients were included in the study. All had cold nodule based on Tc-99m pertechnetate scan.Tc-99m MIBI thyroid scan and FNAC were performed in all the patients. Tc-99m MIBI thyroid scan was performed 20-40 min after intravenous injection of 185-370 MBq of Tc-99m MIBI. Uptake of MIBI in thyroid nodules was compared with that in the surrounding normal thyroid tissue and designation of YY, YN and NN were assigned to each nodule .YY means Intense uptake or uptake more than surrounding normal Thyroid tissue, YN means Uptake is equal or nearly equal to surrounding normal Thyroid tissue and NN means no uptake. FNAC revealed nodular goitre in 29 cases, follicular lesion in 8, cysts and hemorrhage in 10, pleomorph in 2. None of the cystic nodules were YY on MIBI scan, while the follicular lesions showed a variety of MIBI imaging patterns most frequently the YY pattern. None of the follicular lesion showed NN uptake on MIBI scan. In the diagnosis of follicular lesion the sensitivities of YY and YY+YN MIBI uptake patterns were 80% and 100% respectively. The YY+YN MIBI uptake patterns had a negative predictive value of 100% and positive predictive value of 36%, whereas a specificity of 54% was observed. After a cold nodule had been detected using Tc-99m pertechnetate, a second scan with YY or YN MIBI uptake increases the probability that this nodule would be suspicious for malignancy. Having no uptake of Tc-99m MIBI in such nodules very safely excludes the possibility of malignancy. Tc-99m MIBI scintigraphy is a useful method in the differential diagnosis of cold thyroid nodules. High MIBI uptake considerably increases the probability of malignancy and facilitates immediate surgical removal while NN or no uptake actually excludes it. We suggest MIBI scan as a routine diagnostic approach to cold thyroid nodules before fine-needle aspiration cytology