Detection of interleukins-6 and 8 in saliva as potential biomarkers of oral pre-malignant lesion and oral carcinoma: a breakthrough in salivary diagnostics in Pakistan

Oral cancer is at rise in our population due to increasing use of areca nut [Betel nut] with or without tobacco. It is the second frequent malignant tumour for both the gender in Pakistan. This non-interventional case control study was carried out with the aim to explore saliva as diagnostic medium for detecting interleukins [IL] 6 and 8 as biomarkers of pre-malignant lesions [PML] and oral carcinoma. Total 105 subjects were recruited and were divided into three groups "A", "B" and "C" each comprising of 35 subjects. Group "A" comprised of cases with strong clinical evidence of oral PML. Group "B" constitute clinical and histologically proven OSCC and group "C" include disease free subjects as controls. Saliva from all the recruited subjects was procured by drooling method and stored at-20[degree sign]C before further process. All the collected samples were centrifuged at 4500 rpm for 15 minutes at 4[degree sign]C. Supernatant fluid was used in ELISA for detection and quantification of IL-6 and IL-8. Data was analysed by using Chi-square test and multivariate analysis was done by non-parametric test. P-value of 0.05 was taken as standard reference. Significant co-relation was found for qualitative salivary detection of IL-6 and IL-8 among the groups [P<0.001 and <0.0001 respectively]. Regarding quantitative salivary concentration of leukotrienes, no significant co-relation was found in levels of IL-6 among the groups while there was significant association of IL-8 levels between the groups [P<0.0001].On post Hoc multiple comparison, significant co-relation was found among oral PML group and controls [P=0.001] and OSCC group and control [P=<0.0001]. In conclusion salivary detection of IL-6 and IL-8 could be used as probable biomarker for early detection of oral PML and OSCC in etiologically distinct population of Pakistan

Conventional clinical and prognostic variables in 150 oral squamous cell carcinoma cases from the indigenous population of Karachi

Objective: To analyze clinical and prognostic variables of Oral Squamous Cell Carcinoma [OSCC] cases from the indigenous population of Karachi and to correlate with the common risk factor of tobacco habit

Methods: The study was conducted at Ziauddin University, Karachi. One hundred fifty OSCC cases were collected from the Oncology Department of Ziauddin University Hospital, North Nazimabad, Karachi and Otolaryngology ward of Civil Hospital, Karachi, during 2011 and 2015. The reporting included demographic details and variables like intra-oral subsites, clinical stage and histological grade. Recurrence of tumor after initial resection was also documented

Results: The patient's population comprised of 98 males and 52 females. The mean age was 47.1 +/- 12.22 [range:20-78 years]. Maximum numbers were seen in the 41-50 years age group. Urdu-speaking community was the most affected ethnic group [n=75]. Clinico-pathological analysis revealed that majority of cases were moderately differentiated [59%] and were either clinical stage II [35%] or IV [29%] tumors. The most common intra-oral subsite came out to be buccal mucosa of cheeks [56%] followed by lateral borders of tongue [21%], lips [13%], alveolar [6%], palate [2.6%] floor of mouth [1.3%], etc. Recurrence was observed in 08 out of 150 cases. All patients underwent primary resection +/- neck dissection and reconstruction where possible

Conclusions: Overall experience with oral squamous cell carcinoma shows that it has a high tendency for local invasion as well as dissemination to regional lymph nodes, i.e. cervical lymph nodes, both are associated with a poor prognosis. Preventable risk factor of tobacco chewing has been observed in majority of these cases

Beneficial anti-Parkinson effects of camel milk in Chlorpromazineinduced animal model: Behavioural and histopathological study

Potential roles of natural products have been identified for preventing or treating various diseases. Our aim was to investigate the effectiveness of camel milk in an animal model of Parkinson's disease and compare it with standard treatment [levodopa + carbidopa combination]. 40 Wistar albino rats weighing 200-250 gram were divided into four groups of 10 animals each. Group I was kept on water and served as normal control, group II served as negative control, treated with chlorpromazine [5mg/kg i.p.], group III was given camel milk [33ml/kg p.o] and group IV the standard combination of levodopa + carbidopa [100+10mg/kg] respectively, 30 minutes after chlorpromazine treatment. All animals were subjected to the drugs treatment for 30 days. Catalepsy was assessed by Bar test on day 21 and day 30 at 30, 60, 90 and 120 minutes interval. On 30th day animals were sacrificed and whole brains were examined for histopathological changes. The results revealed highly significant [p

Immunohistochemical profile of Hodgkin and Non-Hodgkin lymphoma

Objective: To analyze the frequencies of histological types of lymphoma, diagnosed with complete immunohistochemical profile in younger and older age group

Study Design: Cross-sectional analytical study

Place and Duration of Study: Dow Diagnostic Research and Reference Laboratory, Dow University of Health Sciences, Karachi, from January 2009 to September 2013

Methodology: Consecutive cases of lymphomas, which were diagnosed using immunohistochemistry, were analyzed according to WHO classification. Frequency and percentages for different types of lymphomas were calculated. Hodgkin and non-Hodgkin lymphomas characteristics in two age groups of less than and more than 40 years were compared, applying chi-square test

Results: Out of the 318 cases, 79 [25%] were Hodgkin Lymphomas [HL] and 239 [75%] were Non-Hodgkin Lymphomas [NHL]. Mixed Cellularity Hodgkin Lymphoma [MCHL] was the commonest [n=48]. Amongst the NHL, 215 [89.95%] were B cell lymphomas and 24 [10.05%] were T-cell lymphomas. Diffuse Large B-Cell Lymphoma [DLBCL] was the commonest lymphoma [n=165, 69.95% of NHL]. Anaplastic T-Cell Lymphoma [ALCL, n=10] was the commonest T-cell lymphoma. The frequency of HL was significantly higher in the younger age group and that of NHL was higher in the older age group [p < 0.001]. Primary lymph node involvement was reported in 175 [55%] and cervical lymph node was the most frequent site. Extra nodal involvement was seen in 93 [29%] of all cases and was reported in 87 [36.4%] of NHL and 6 [7.5%] of HL. The most common extra nodal site was the gastrointestinal tract

Conclusion: Hodgkin lymphoma comprises 25% and non-Hodgkin lymphoma comprises 75% of all lymphomas. Both occur in younger age groups than reported in the West. B-cell NHL is three times more common than T-cell lymphoma. DLBCL is the most frequent lymphoma. ALCL is the most common T-cell, and mixed cellularity is the most common Hodgkin lymphoma

Salivary detection of human Papilloma virus 16 and 18 in pre-malignant and malignant lesions of oral cavity: Is it feasible in Pakistani context of Socio-Cultural Taboos?

To evaluate salivary detection of HPV-16 and 18 would be feasible and informative biomarker for oral pre-malignant and malignant lesion in our population. This non-interventional, case control study was carried out at department of E.N.T, Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital Karachi, Pakistan between July 2011 to December 2012. Total of 105 cases were recruited. These were divided in three groups 'A', 'B' and 'C having 35 subjects each. Group'A' constitutes patients having strong clinical evidence of oral pre-malignant lesions [PML]. Group 'B' includes historically proven oral squamous cell carcinoma [OSCC] and Group 'C' comprised disease free subjects as controls. After taking informed consent, relevant clinical history was recorded on institutional approved performa. Saliva from all subjects was procured by standard 'drooling method'. Samples were stored at +4°C and later transferred to Laboratory to store at-20°C before further process. Samples werKfcentrifuged at 4500 rpm for 15 minutes at 4°C. Cell pellets sediments were used for identification of HPV-16 and 18 by real-time PCR method. Data was entered and analysed using SPSS version 16. P-value of 0.05 was taken as standard. In group 'A', HPV-16 was detected in 3 [8.6%] cases while HPV-18 was not detected in any of the subject. In group 'B', HPV-16 was detected in 07 [20%] while HPV-18 was found in 06 [17.1%] cases. Mixed HPV-16 and HPV-18 were found in 02 [5.7%] cases. In group 'C, HPV-16 was detected in 03 [8.6%] while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for HPV-18 detection [P= 0.002] while for HPV-16, no significant association was found [P= 0.245]. HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over differences in genetic makeup, environment, indulgence in peculiar risk factor habits, sexual practices and difficult evaluation of the acquisition of viral load due to socio-cultural and religious restrictions could be the reason

Differential immune cell densities in ductal carcinoma In-Situ and invasive breast cancer: possible role of leukocytes in early stages of carcinogenesis

To investigate immune cell densities in pre-neoplastic [DCIS], cancer [IDC] and control breast tissues. A total of four preneoplastic, 104 cancer and 104 control samples were analyzed. Morphological classification and prognostic scoring along with quantification of immune cells/mm[2] was performed. Data were entered and analyzed using SPSS version 16. Correlation of immune cell densities with various tumour sub-types was investigated using paired t-test and ANOVA. A p-value of <0.05 was considered as significant. Our data show increased infiltration of lymphocytes [mean lymphocytes = 287.6 cells/mm[2]] as well as myelocytes [mean lymphocytes = 117.1 cells/mm[2]] in pre-neoplastic tissues. This infiltration was significantly high compared to cancer [p-value<0.001] as well as control tissues [p-value <0.001]. Moreover, we report increased infiltration of lymphocytes in cancer tissues compared to controls [p-value<0.001]. There was no difference in lymphocyte densities within various tumour sub-types [all p-values >0.05]. Leukocytes may play a role in early stages of breast carcinogenesis

Ductal and acinar adenocarcinoma of prostate: morphological and immunohistochemical characterization

We sought to characterize the ductal and acinar subtype of prostate adenocarcinoma using hematoxylin and eosin [H and E] staining and an immunohistochemical antibody cocktail. We also investigated the clinical features, prostate-specific antigen [PSA] levels, and biological aggressiveness of these tumors. We utilized tumor bearing prostate biopsies, obtained between 2010 and 2014 from Dow Diagnostic Research and Reference Laboratory, to identify cases of prostatic ductal and acinar adenocarcinoma using routine H and E and immunohistochemical staining. The immunohistochemical antibody cocktail 34beta E12/p63/AMACR was used for staining. The association of clinicopathological variables including patient's age at diagnosis, Gleason score, and PSA levels before surgery was retrospectively analyzed. A total of 10 ductal and 140 non-ductal cases were identified. Ductal cases were predominantly high grade with advanced histopathological features [90%; p=0.030]. Marked elevation in PSA level was also reported in most cases. No other significant statistical difference was observed. Pathological and immunohistochemical examination could be used to characterize ductal and acinar adenocarcinoma of the prostate. Ductal adenocarcinoma of the prostate is a rare subtype of prostate carcinoma and is be more likely to present with advanced grade cancer suggesting that timely detection of the disease is vital

Molecular diagnosis of oral pre-malignant lesions and oral squamous cell carcinoma in saliva-a breakthrough in Pakistan

To evaluate salivary detection of interleukin 6 and 8 and high risk HPV-16 and 18 are informative biomarkers of Oral Pre-malignant Lesion [PML] and Oral Squamous Cell Carcinoma [OSCC] in our population. July 2011 to December 2012. Total 105 cases were included. The subjects were divided in three groups 'A', 'B' and 'C' having 35 participants each. Group 'A' comprised of patients having strong clinical evidence of oral PML. Group 'B' constitutes histologically proven OSCC and Group 'C' includes disease free subjects as controls. Relevant clinical history was recorded after informed consent on institutional approved performa. Saliva was collected as per standard drooling method'. Samples were stored at +4oC and later transferred to Dow Diagnostic, Research and Reference Laboratory to store it at -20oC before further process. Samples were subjected to centrifugation at 4500 rpm for 15 minutes at 4oC. Supernatant fluid phase was used in ELISA for detection and quantification of IL6 and IL8. . Cell pellets were used for identification of high risk HPV-16 and 18 by real-time PCR. Data was entered and analyzed on SPSS version 16. P-value of 0.05 was taken as standard reference. In group 'A', IL6 was not detected in almost all the subjects except one case. IL8 was detected in 26/35 [74.3%] subjects and not detected in 09 [25.7%] cases. In group 'B', IL6 was detected in 13 [37.1%] cases and in 22 [62.9%] cases, it cannot be detected. IL8 was detected in 33 [94.3%] and it was not detected in 02 [5.7%] subjects. It is observed that IL8 is consistently found raised in group 'A' and 'B'. In group 'C', IL6 was not detected in any of the subject while IL8 was detected in 10[28.6%] cases. Significant association was found for qualitative salivary detection of IL6 and IL8 between the groups [P= < 0.0001 and < 0.0001 respectively]. Regarding quantitative salivary concentration of IL6 and IL8, no significant co-relation was found in salivary levels of IL6 between the groups while there was significant association of salivary IL8 levels between the groups [P= <0.0001]. On post Hoc multiple comparison, significant co-relation was found in IL8 levels between oral PML group and controls [P=0.001] and OSCC group and controls [P= <0.0001]. In group 'A', HPV-16 was detected in salivary samples of 3 [8.6%] cases while HPV-18 was not detected. In group 'B', HPV-16 was detected in the salivary samples of 07 [20%] cases while HPV-18 was detected in 06 [17.1%] cases. Mixed HPV-16 and HPV-18 were found in 02 [5.7%] cases. In group 'C', HPV-16 was detected in 03[8.6%] cases while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for salivary HPV-18 detection [P= 0.002] while for detection of HPV-16, no significant association was found [P= 0.245]. Salivary concentration of IL6 and IL8 in oral PML and oral cancer are useful biomarkers in our population. Detection of HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over different genetic makeup, environmental and geographic differences, indulgence in peculiar risk factor habits and different sexual practices compared to west due to socio-cultural and religious restrictions could be the reason

Familial, hereditary and sporadic characterization of prostate cancer and impact on diagnostic modalities

Background: A family history of prostate cancer has been associated with increased risk of prostate cancer development, but the risks were inconsistent in terms of the affected family members and the data on prostate cancer characterization with respect to family history of disease among Pakistani men is limited

Objective: To characterize prostate cancer based on family history into familial including hereditary and sporadic cases and to investigate the association with diagnostic modalities; age of patient at diagnosis and pathological tumor grade

Methods: A self-administered written questionnaire was forwarded to 100 patients diagnosed with prostate adenocarcinoma, containing questions about age at diagnosis and cases of prostate cancer in family. The information regarding age of patient at diagnosis, cases of prostate cancer in relative, pathological tumor grade and age at death for all relatives affected by prostate cancer was acquired. The data was validated through the biopsy report of patient and medical records of relative affected by prostate cancer, provided by patient respectively. Patients were then divided into three groups according to their family history: familial prostate cancer [FPC], hereditary prostate cancer [HPC] and sporadic prostate cancer [SPC] groups

Results: 17% of the patients were categorized in the FPC group, of which 2% were identified as having HPC and 81% were assigned SPC group. Overall, there was no significant statistical difference between groups and study variables

Conclusion: We found no difference in age and pathological tumor grade, in patients diagnosed with adenocarcinoma of prostate following TURP. These results are consistent with previous studies except that patients with HPC in previous studies were significantly younger at diagnosis

Alterations in mitochondria of kidney tubules by different doses of diclofenac sodium in rabbits

Diclofenac sodium, a Non-Steroidal anti-inflammatory agent [NSAIDs], is being prescribed since many decades for the treatment of rheumatic diseases as well as for the relief of pain and fever. It is the inhibitor of enzyme cyclooxygenase. Unfortunately its use is often accompanied by gastro-intestinal renal and hepatic side effects. Renal dysfunction is characterized from acute renal failure to chronic injury. We herein report the damaging effect of diclofenac sodium on the ultrastructure of PCT of rabbit kidney by increasing the doses above the recommended. Experimental Study. This study was conducted at the Institute of Basic Medical Sciences [IBMS], Dow University of Health Sciences from March 2009 to March 2010. In this study 88 male albino rats were selected, they were divided into 4 groups group A received normal saline 2 ml/kg, group B diclofenac sodium 2mg/kg body weight group C 4 mg/kg and group D 6 mg/kg for two weeks. At the end of experiment animals were sacrificed, dissected, kidneys were identified, fixed in 4% gluterldehyde than 1% osmium tetraoxide and passed through graded alcohols, infiltrated and embedded in resins. Semithin 3-4 microm sections were stained with toluidine, ultrathin 1microm with uranyle acetate. Tissue sections were observed under transmission electron microscope. Tissue changes were graded as 0, +, ++ and +++, no change, mild moderate and severe changes respectively. The results were then analyzed statistically. There were non-significant changes in the cell organelles of PCT in group A and B, while significant changes were observed in group C and highly significant in group D. Diclofenac sodium has damaging effect on the mitochondria of PCT cells far before the light microscopic changes. So its use should be restricted only in very painful conditions. Secondly in case of prolong treatment follow up with regular renal function test should be carried out

Adverse effects on cardiovascular status and lipid levels of albino Wistar rats treated with cisplatin and oxaliplatin in combination with 5 Fluorouracil

The study was designed to comparatively assess direct damages on cardiac tissues and aorta associated with abnormalities in lipid profile and cardiac biomarkers induced by two platinum cytotoxic compounds with and without 5FU [5Fluorouracil] in rats

Albino Wistar rats were treated with 5FU [15mg/kg], cisplatin [0.8mg/kg] and oxaliplatin [0.8mg/kg] in different dosing schedules. The changes in the lipid levels, CPK and Tropinin I levels, following treatment with single and combination schedules of CDDP, 5FU and Oxaliplatin were compared with the control group maintained on normal saline. Changes in LDL and cholesterol levels were highly significant in cisplatin and oxaliplatin treated rats. Myofibrillar loss and vascular wall thickening was seen in cisplatin treatment groups in the acute model of toxicity

The damages were mild but progressive. Tropinin I levels were raised well above diagnostic risk levels in the delayed model of toxicity in the rats treated with oxaliplatin in combination of 5FU, indicative of definite cardiotoxic potential of oxaliplatin in combination of 5FU mimicking the FOLFOX regimen

Detection of xenotropic murine leukemia virus-related virus in prostate biopsy samples

To determine the association of Xenotropic murine leukemia virus related virus [XMRV] infection with prostate cancer and compare it with benign prostate hyperplasia. Case control study. Department of Histopathology and Molecular Pathology, Dow University of Health Sciences, Karachi, from January 2009 to December 2012. XMRV was screened in 50 prostate cancer and 50 benign prostatic hyperplasia biopsies using conventional end-point PCR. Other studied variables were family history of prostate cancer, patients age and Gleason score. XMRV was detected in 4 [8%] of the 50 prostate cancer biopsy specimens compared to none in biopsies with benign prostatic hyperplasia. However, there was no significant statistical association of XMRV infection with the other variables. A low frequency of XMRV infection was found in this case-control study. Men, who harbor XMRV infection, may be at increased risk of prostate cancer but this needs to be investigated further at a larger scale

In vitro/in vivo effect of Citrus limon [L. Burm. f.] juice on blood parameters, coagulation and anticoagulation factors in rabbits

The genus Citrus of the family Rutaceae includes many species e.g. Citrus indica, Citrus aurantifolia and Citrus limon, among which Citrus limon L. Burm. f. has been reported to have highest antimicrobial activity. It is used as antidote against certain venom, due to its platelet inhibitory effect and also reported to have hypocholesterolemic effect. However its anticoagulant and thrombolytic effect were not been investigated, hence a prospective in-vitro/in-vivo study was designed to determine the effect of Citrus limon on blood parameters, coagulation and anticoagulation factors. Invitro tests revealed highly significant increase in thrombin time and activated partial thromboplastin time by Citrus limon, whereas fibrinogen concentration was significantly reduced in comparison to control, however prothrombin time was not affected significantly. In-vivo testing of Citrus limon was done at three different doses i.e. 0.2ml/kg, 0.4ml/kg and 0.6ml/kg in healthy rabbits. Significant changes were observed in hematological parameters such as erythrocytes, hemoglobin and mean corpuscular hemoglobin concentration. Bleeding time and thrombin time was significantly prolonged and there was increase in protein C and thrombin antithrombin complex levels. These results may be due to inactivation of thrombin because it significantly decreases fibrinogen concentration and inhibit platelet aggregation. Citrus limon showed maximal anticoagulant effect at 0.4ml/kg, which suggest that Citrus limon possesses an antithrombin component and could prevent thrombosis playing a cardio protective role

Ultrasound based evaluation of hepatic steatosis and fibrosis in hepatitis c non-responders

To determine the accuracy of ultrasound in the diagnosis and grading of steatosis and fibrosis in Hepatitis C [HCV] patients not responding to ribavarin-interferon therapy. A cross-sectional, analytical study. Radiology Department, Civil Hospital, Karachi, from March 2008 to August 2010. Patients with positive HCV RNA despite 24 weeks ribavarin-interferon therapy [non-responders] were subjected to ultrasound and biopsy prior to institution of pegylated interferon therapy for detection and grading of steatosis and fibrosis. Using histopathology as the gold standard, sensitivity, specificity, negative and positive predictive values for ultrasound were determined. The sensitivity of ultrasound for hepatic steatosis was 90.9% for no steatosis [NS], 100% for moderate and gross steatosis and 84.4% for mild steatosis with 100% specificity. The senitivity for fibrosis was 25% for no fibrosis, 100% for mild fibrosis, 89.74% for moderate fibrosis and 100% for gross fibrosis. The overall accuracy for detection of steatosis was 95.39% and that for fibrosis was 98.02%. Hepatic vein showed increased dampening of flow with advancing grades of steatosis and fibrosis. Ultrasound has a high accuracy in the diagnosis and grading of steatosis and fibrosis in HCV non-responders. Mild fibrosis may confound the diagnosis of mild steatosis

Clinico-pathological parameters of 50 Oral Squamous cell carcinoma cases in Karachi

Background: The incidence of oral squamous cell carcinoma remains high in Indo-Pak region. Worldwide oral and oropharyngeal carcinomas are the sixth most common cancers. A number of clinic-pathological parameters have been implicated in prognosis, recurrence and survival for this tumor. As a very high frequency reported in major hospitals of Karachi, this study documented some of the well known clinicpathological parameters in the indigenous population of Karachi

Objective: To analyze the clinicopathological parameters of cases of OSCC in the population of Karachi

Methods: The study protocol was approved by the Ziauddin University ethics committee for human research. The patients' data was entered onto questionnaires. The reporting included a range of clinical, operative and histopathological variables. Recurrence of tumor after initial treatment was also documented

Results: The patients' population comprised 31 males and 19 females. The mean age was 45.56 [SD + 12.08]. Minimum age was 15 years, while maximum was 75 years. Pathological analysis revealed that majority of SCC cases were moderately differentiated SCC with clinical stage T2 or T3, N0,M0/N1,M0. Most common oral sites came out to be buccal mucosa of cheeks followed by lateral borders of tongue and lips. All patients underwent primary resection +/- neck dissection and reconstruction when necessary

Conclusion: Overall experience with OSCC shows that it has a high tendency to disseminate to regional lymph nodes, i.e. cervical lymph nodes, as well as to re-emerge at the primary site after resection

Magnitude of breast diseases in OJHA histopathology department

This study evaluates the current status regarding spectrum of breast diseases from the data record of Dow Diagnostic Research and Reference Laboratory [DDRRL], Karachi. Descriptive study. This study was carried out on obtaining Data of various breast diseases was obtained from the histopathology department of Dow Diagnostic Research and Reference Laboratory [DDRRL], OJAH campus located in Karachi from October 2011 till December 2011. Ten months data of 2011 consisted of 829 cases of breast diseases. The diseases were grouped into malignant, benign and inflammatory types. There was no limitation of age and both genders were considered. Cancers other than breast diseases were excluded from the study. Reports of missing information were not analyzed. Normal breast tissue was as well excluded. Analysis revealed 413 as malignant lesions, 322 benign and 80 inflammatory .In malignant tumours invasive ductal carcinoma grade 2 was [23.7%]. Fibroadenoma [28.0%], fibrocystic change [6.1%], benign phylloides [2.4%], lipoma was 1.2% and no record of lactating adenoma was found. Inflammatory lesion breast abscess [4.0%], chronic mastitis [1.7%], granulomatous mastitis [1.7%], duct ectasia [1.3%] and fat necrosis was least diagnosed. Breast diseases trend in the women of Karachi are changing. Malignant breast lesions are presenting at younger age and its occurrence is more than benign and inflammatory lesion altogether in this study

Emerging patterns in clinico-pathological spectrum of oral cancers

To correlate the clinico-pathological aspects of Oral Squamous Cell Carcinoma [OSCC] with risk factors to determine the present status and variations in the profile. One hundred patients of OSCC and one hundred age and sex matched controls were selected. Detailed demographic data, regarding age, gender, marital status, ethnicity, religion, socio-economic status along with habits, betel quid, tobacco chewing / smoking, alcohol and dietary habits was recorded. Detailed oral examination was carried out for the site of involvement and associated pathology. Histological grade was determined on microscopic examination of Hemotoxylin and Eosin [H and E] stained slides. One hundred age and sex matched controls were also evaluated for this study. Ages of patients ranged from 25 to 80 years with mean age being 47.84 +/- 12.18[SD]. Maximum cases were detected in the fifth decade. Male: Female ratio was 2.8:1. Age in controls ranged from 22 -73 with male to female ratio being 3.54:1. In patients, most tumors were seen in buccal cavity [54%] followed by tongue [24%]. Histologically 60% cases were well differentiated. Strong association with tobacco smoking and chewing, betel quid and its substitutes was detected, with smoking being more prevalent in males and betel quid in females. Significantly less number of controls were observed to be involved in these habits, with almost half having no such addictions. The present clinico-pathological status of oral cancer still emphasizes primary prevention by creating awareness against the devastating effects of tobacco use, betel quid, its substitutes and areca nut, which can go a long way in decreasing the incidence of this disfiguring and lethal condition

clincopathological correlation of hysterectomies: a hospital based surgical audit

To determine correlation of clinical indication of hysterectomies with histological findings and association with age and parity. Institution based cross sectional study. This study was conducted at the Lady Dufferin Hospital, Karachi, Pakistan from Jan. 2007 to Dec. 2009. 322. Non Probability Purposive sampling. A structured standardized Proforma was used to collect data between Jan 2007 to Dec 2009 from the pathological laboratory data on surgical hysterectomies. The data comprised of clinical, physical and histological examination. The analysis was made on correlation of clinical indication of hysterectomies with histological findings and association with age and parity. Correlation of Clinical Indications and histological findings on uterus [endometrium and myometrium], cervix and ovaries. Three hundred twenty two abdominal hysterectomies were studied. Among the study subjects the mean +/- SD age was 42.36 +/- 6.36. Only 12 [3.7%] women were unmarried. Clinically the commonest indications were Leiomyoma in 167 [519%] and DUB 120 [37.7%]. Ovarian mass was clinical indication in 4 [1.3%] cases. Histopathology revealed leiomyoma 149 [46.3%] as the commonest uterine pathology, followed by adenomyosis. Inflammation with squamous metaplasia 252 [78.2%] was the most common pathology noted in the cervix whereas 101 [46.4%], cystadenomas were noted in 6 [2.8%] and Benign teratoma in 3 [1.4%]. Hysterectomy is a major gynecological procedure therefore it should be performed after accurate clinical assessment and with proper and justified indications

Frequency of head and neck lesions according to histopathologic diagnosis

Retrospective study is conducted to determine the frequency of head and neck lesions histopathological diagnosis and to contribute in base line data of head and neck lesions at DDRRL/OJHA campus, Karachi. The study includes data from 2nd February 2008 to 31st December 2010. The most common head and neck lesions affecting male 53.9% [n=758] and female 46.04% [n=647]. Patients of all age group are included. Both incisional and excisional biopsies are included and previously diagnosed lesions on the basis of histopathology are excluded. Among 1,405 head [n=860] and neck [n=545] biopsies, Squamous cell carcinoma was 399. The most frequently affected site of oral cavity was right buccal mucosa with OSCC. Thyroid goiter was most commonly reported neck lesions. This study showed that premalignant lesion was less commonly submitted biopsies as compare to malignant lesions

En bloc resection of huge cemento-ossifying fibroma of mandible: avoiding lower lip split incision

Cemento-ossifying Fibroma [COF] is an osteogenic benign neoplasm affecting the jaws and other craniofacial bones. It commonly presents as a progressively slow growing pathology, which can sometimes attain an enormous size, causing facial deformity. A case of a huge cemento-ossifying fibroma, appearing as a mandibular dumbbell tumour in a male patient is documented, which caused massive bone destruction and deformity. It was surgically removed by performing en bloc resection of mandible avoiding the splitting of lower lip incision technique, thereby maintaining his normal facial appearance