RESUMO
To determine the frequency of HPV in eaters of Gutka [betel, areca, lime and tobacco concoction], presenting with oral lesions. A descriptive study. Ziauddin University Research Laboratory, from February to July 2010. Subjects munching Gutka fulfilled the inclusion criteria. Samples were collected in the form of 20 - 40 ml oral rinse from 262 subjects who were habitual eaters of Gutka after an informed consent. Gentle brushings from the lesion were taken from subjects with the help of a brush at the other end of dental floss and the oral rinse was stored at 4[degree sign] C until DNA extraction. DNA was extracted and PCR was performed using HPV consensus primers Gp5+/Gp6+. Oral cavity was examined for the presence of ulcer, trismus, sub-mucosal fibrosis, leukoplakia and/or warts. Out of 262 subjects, 42 were females and 220 males with an average age of 27 +/- 10 years. HPV was positive in 47 subjects [17.9%]. HPV frequency was 2.7% greater in chewers with more than 10 years of habit compared to less than 10 years. Examination of oral cavity showed 78% presenting with more than one complaint including oral ulcers [25%], rough mucosa [62%], sub-mucosal fibrosis [24%], leukoplakia [20%] and erythroplakia [10.6%]. Highest frequency of HPV was observed in erythroplakia [25%]. Association between presence of symptoms and HPV shows an ODDS RATIO: ad/bc= 4982/430=11.6. Oral lesions caused by constant exposure to Gutka are associated with high frequency of HPV infection, which may be a risk factor for squamous cell carcinoma of the oral cavity. People should be educated about the consequences of Gutka abuse
RESUMO
To define the role of serum markers of inflammation total leukocyte count, neutrophil percentage in diagnosis of acute appendicitis. Study Cross sectional analytic study. Surgical emergency and surgical unit-lV Nishtar Hospital Multan during July 2005 to March 2006. Study was carried out on 50 patients of either sex, above the age of 13 years presented with pain right side of the abdomen. These patients were subjected to complete blood examination including TLC and DLC. Of the 50 patients, 39 patients [78%] had TLC raised above 10.000 per mm[3] out of which 36 [72%] had inflamed, gangrenous or perforated appendicitis and 3 [6%] had normal appendicitis confirmed on histopathology. 11 patients had TLC below 10.000 per mm[3]. They all had inflamed appendicitis confirmed on histopathology. The sensitivity and specificity of TLC in the diagnosis of acute appendicitis were 76.6% and 33.3% respectively. The positive and negative predictive value were 92.3% and 9% respectively. The leukocytosis was attributed to the neutrophils leukocytosis associated with lymphopaenia. In this study there were 3 [6%] patients who had TLC below 10.000 mm[3] but they had neutophils to lymphocyte ratio 3.5:1 or above. They had inflamed appendices on histopathology. Laboratory test of white cells count and neutrophil percentage are more effective in supporting clinical diagnosis of acute appendicitis