Immunological study of type 2 diabetic patients with periodontal disease

To evaluate the IgA, IgG and IgM levels in the serum samples of type 2 diabetic and Periodontal patients of the Peshawar area having different life style set up. Case control study. This study was carried out on subjects who fulfilled our criteria and agreed to participate in the study were included. They were residents of Peshawar area and visited OPDs of Khyber College of dentistry, Peshawar during July, 2012 to June, 2013. Among 120 participants, 30 were healthy, 30 were with periodontitis, 30 had diabetes and the remaining 30 had both diabetes and periodontitis. All of them had at least 20 natural teeth. Diabetic patients had the disease history minimum of five years while the periodontal patients had clinically confirmed the disease. Blood samples were collected from each of the participant and immunoglobulins A, G and M were measured. The observed data were analyzed accordingly through standard statistical methods. Male patients were found more as compared to females [ratio 1: 0.87] in the two diseases. The age range was 35 to 54 years with the mean 44 +/- 5. As per HBA1C results; 40% had good control of diabetes, 26% moderate while in 34% control was poor. Immunoglobulin A and G levels were found significantly higher [p < 0.05] in the three disease groups as compared to control group. Whereas the concentration of IgM was not changed by the said diseases. Besides, the gender has no influence on the levels of the three immunoglobulins. The IgG levels increased with the increase in severity of the Periodontitis disease. While IgA showed slight decrease with the increase in clinical grades of the Diabetes disease. The result of the current study indicates the role of humoral immune response in the two mentioned diseases. The higher levels of immunoglobins particularly IgA and IgG might be due to protective mechanism against the weak immune response and the increased bacterial challenge in diabetes and periodontitis

Pattern of cigarette smoking among college students of Quetta

Cigarette smoking habit is developed more at the young age, hazardous to health and causes premature mortality. To determine the pattern of cigarette smoking and factors contributing to the said habit among college students of Quetta. Randomized study. This study was conducted at the Bolan Medical College, Quetta during the academic year 2010-2011. a total of 850 students from different colleges of Quetta were randomly selected during the academic year 2010-2011. Prevalence and influence of factors associated with the cigarette smoking were recorded on a predesigned questionnaire. The collected data was analyzed with the help of statistical procedures. Out of the total, 122 students were smokers, 23 ex-smokers and 705 non-smokers. Smokers had the habit for charm and relaxation. While non-smokers and ex-smokers avoided cigarettes use due to family blame, religion and its adverse effect on health. Besides, the habit was found more common among students whose fathers and brothers were smokers. Majority of them knew the hazards and very little number was smoking in the public places. Young age and transition period from school to college is a critical time to adopt the habit of cigarette smoking, hence needs an immense attention of the authority designing tobacco control policies. Healthy recreational activities, awareness programs related to its hazards, non-smoking home environment, increased tax and ban on its advertisements are the essential measures, which can minimize the habit. In addition, the present basic work would serve as a template to conduct further advanced studies on this line

Diurnal variations in the levels of progesterone during late pregnancy

Progesterone is a C-21 steroid hormone, plays a major role in the occurrence, maintenance and termination of pregnancy. To study the diurnal variations in the levels of progesterone at the start and end of the day during late pregnancy in women having different life set ups. Experimental and Observational Study. This study was conducted at the Department of Gynae and Obs., Khyber Medical College, Peshawar. Blood samples of 50 women between 26-40 weeks of gestation were collected at two different intervals with a gap of 12 hours. Progesterone level was estimated by Serozyme EIA method. The concentration of progesterone was found low in the early morning and high in the late evening in our population. Besides, the magnitude of fluctuations in the samples of two different intervals declined with progress of age and weeks of gestation. Our findings support the recommendation of restricting progesterone measurements to morning hours at all ages particularly during late pregnancy which is important information for clinicians at the time of interpretation of results

Tinnitus matching

To study the pitch and loudness of tinnitus and to find minimal masking level. Descriptive analytical study. This study was conducted at Combined Military Hospital Rawalpindi, the tertiary referral center for Pakistan Armed Forces from 1998 to 2001. Patients with tinnitus were included in the study. Exclusion criterion was transient tinnitus settling on removal of offending agent like foreign body and not having tinnitus as major presenting feature. Patients were thoroughly interviewed and tinnitus card [questionnaire] was filled. Thorough general physical and Ear Nose Throat examination was carried out including relevant tests to elucidate any cochleovestibular pathology. All patients had pure tone audiometery and tinnitus testing and sophisticated investigations were carried out whenever indicated. Most patients of tinnitus were seen between age of 40 to 60 years and 76.6% patients were male. Hearing loss accompanied tinnitus in 90% patients and 53% patients had tinnitus of moderate intensity. Pitch match frequency of 4 kilohertz was seen in 25.3% while 29% patients had loudness match of tinnitus ranging from 55 to 70 decibel [dB]. In vast majority [24%] minimal masking level ranged from 41 to 55 dB. Seventy nine percent patients had pitch match frequency at or around frequency of maximum hearing loss. Tinnitus is seen predominantly among males and its frequency increases with age .It is usually of moderate intensity and is of high pitch which corresponds to frequency of maximum hearing loss. Pitch of tinnitus is not a good indicator of degree of annoyance while loudness match gives a good measure of annoyance. Minimal masking levels are at or around loudness match. Tinnitus in majority of patients is associated with mild to moderate degree of hearing loss

Acquired spontaneous intercostal hernia

A case of acquired spontaneous intercostal hernia is being presented. The aetiology, clinical features, radiological findings and management are discussed

Rectus sheath haematoma presenting as acute abdomen

Rupture of epigastric vessels or tearing of the recuts abdominis fibres causes rectus sheath hematoma. Diagnosis can be difficult; a high index of suspicion is essential to prevent unnecessary surgery. Investigations of choice are an abdominal ultrasound and CT scan but the former may not always be helpful and the latter not always available. We are reporting a case that was properly diagnosed and treated on clinical grounds only

Small intestinal perforation caused by tape worm

Infestation with tapeworms is common and does not always have serious sequelae. Howerver, some times they can cause serious problems including intestinal perforation. We are reporting a rare cause of intestinal perforation cauded by a 360 cms long tapeworm

Brunner's gland adenoma: Case report with review of literature

Brunner's gland adenoma is a rare benign tumor of the duodenum. Less than 150 cases have been reported in the literature. We are reporting the case of a 50 years old lady who presented with upper gastrointestinal symptoms. An abdominal ultrasonography showed hydatid cyst of liver, but on laparotomy a duodenal mass was found which turned out to be Brunner: gland adenoma on histopathology. A review of literature is being presented

Giant hydronephrosis presenting as acute abdomen

We are reporting an interesting case where the right kidney had undergone hydronephrosis of gigantic proportion due to ureteropelvic junction obstrucion. The patient presented as an acute abdomen with no history of trauma. On laparotomy, he was found to have giant hydronephrosis of the right kidney with extensive oedema of the retroperitoneum due to leakage of urine

Metastatic carcinoma of the gall bladder presenting as obstructed inguinal hernia

Metastatic deposit of an intra-abdominal malignancy in the sac of an inguinal hernia is a rare phenomenon. This is the case report of an elderly gentleman who presented to us with metastasis in the sac of a left inguinal hernia from carcinoma of the gall bladder

Peptic ulcer: double duodenal perforation

We are reporting a rare case of giant anterior duodenal ulcer perforation, together with a concomiant posterior ulcer perforation. The patient came from Afghanistan with five days history of generalized peritonitis, septic shock and renal impairment. Since it was impossible to repair the perforations by the usual method of omentopexy, an antrectomy and Roux-en-Y gastrojejunostomy was performed. The patient recovered uneventfully and was in a satisfactory condition during regular follow-ups

Lichtenstein tension-free hernioplasty: an audit

This prospective, observational study was carried out to assess the feasibility of prosthetic repair for groin hernias in terms of infection, recurrence and cost-effectiveness in a government hospital set-up and to disprove the commonly held notion that using a mesh for groin hernia repair in our tertiary care teaching hospitals is expensive and can lead to infection. A total of 174 hernioplasties were carried out in 166 patients for primary inguinal hernia in the Department of Surgery, Jinnah Hospital Lahore, over a period of four years, starting from March 1999 to March 2003. Only males over 25 years of age, without any co-morbid diseases were selected. The patients were operated mostly under spinal anaesthesia, with three doses of a single antibiotic perioperatively. The patients were followed-up physically for four years on an out door basis. Only one [0.6%] recurrence and two [1.2%] superficial infections were noted. There was no deep-seated infection or any graft rejection. Urinary retention occurred in 9 [5.3%] cases, while hydrocele and haematoma occurred in three cases [1.7%]. There was no ischaemic orchitis, deep vein thrombosis or a varicocele following mesh repair. There was no effect on fertility in these patients. There was minimal pain with early return to work and, hence, minimum expenses. It is concluded that Lichtenstein Tension-Free Hernioplasty is a safe and effective procedure that can be performed in a government hospital under spinal and local anaensthesia with very low infection and recurrence rates. It has a good patient compliance due to early mobility and early return to work. All these factors make it cost effective as well