Non-malignant lesions; clinico-pathological profile of nasal cavity and paranasal sinuses

The presence of a mass in the nasal cavity and paranasal sinuses may seem to be simple problem, but it is very difficult to differentiate clinically from potentially malignant tumors. To evaluate the clinical presentation and histopathological features of the non malignant lesions of nasal cavity and paranasal sinuses. Prospective descriptive study. Study was carried out in departments of Paediatrics and ENT at Ghulam Muhammad Mahar Medical College Hospital Sukkur from Jan 2009 to Dec 2012. The study included all cases of nonmalignant masses of nasal cavity and paranasal sinuses, those attended the Paediatric and ENT department and underwent the surgical intervention. One hundred twenty non-malignant cases were enrolled for this study. A separate pro-forma was filled to record the cases biodata, history, clinical examination, investigations and histopathological diagnosis. All histopathologically proven malignant masses were excluded from the study. Out of 120 cases 78 [65%] were males and 42 [35%] were females, with M:F ratio of 1.8:1. The age of presentation ranged from 8 years to 70 years and mean age was 26.3years. Sinonasal masses were found to be bilateral in 20 cases [16.67%], right sided in 65 [54.17%] and left sided in 35 [29.16%] cases. The main presenting symptoms were nasal blockage 110 [91.66%], nasal discharge 102 [85%], sneezing 60 [50%], hypoinsomnia 36 [30%], epistaxis 24 [20%], headache 20 [18.33%] and mouth breathing 18 [15%] cases. Polyp was the most common lesion in 86 [71.66%] cases observed in this study. The common histopathological diagnosis was simple inflammatory nasal polyp in 48 [40%], allergic nasal polyps 30 [25%] and fibroepithelial polyp in 8 [6.7%], inverted papilloma in 12 [10%], angiofibroma 6 [5%], capillary hemangioma 4 [3.34%] and rhinosporidiosis 4 [3.34%] cases. Sinonasal masses have various differential diagnoses and are still thought to be simple problem in our society. There is a need for early recognition and referral to ENT surgeon and need histopathological examination of every mass to confirm the diagnosis

Vitamin D levels in OPD patients in teaching hospital Sukkur

It is well established that low levels of 25 [OH] Vitamin D [<30 ng/dl] are a common finding world over, affecting over a billion of the global population. Aches and pains in joints and muscles are frequently seen in patients with Vitamin D deficiency and patients are misdiagnosed with other diseases. To determine the level of Vitamin D in patients attending outpatient department with aches and pains. Prospective and observational. This study was conducted at Orthopedic department of Ghulam Muhammad Mahar Medical College Hospital [GMMMCH], Sukkur from February 2011 to March 2012. All patients attending orthopaedic OPD of GMMMCH with aches and pains had their Vitamin D level done. They were divided in three diagnostic categories based on their serum 25 [OH] Vitamin D levels. Those with below 8 ng/dl were categorized to have severe deficiency, levels between 8-19ng/dl as moderate deficiency and levels of 20-29 ng/dl as mild deficiency. A total of 400 patients were studied. Minimum age was 15 years and maximum age was 75 years. Serum Vitamin D level was found low [<30 ng/dl] in [92%] patients. Their mean age was 44.3 +/- 18.3 years, with female to male ratio 4:1. Ten percent [10%] had severe, 60% moderate and 30% had mild deficiency. We observed high proportion of patients with aches and pains having low levels of Vitamin D. The specific cause [s] for this observed high prevalence of low 25 [OH] vitamin levels are not clear and need to be investigated further upon

Knowledge, attitude and practices of barbers about hepatitis B and C and its transmission in Larkana city, Pakistan

Blood borne diseases impose heavy burdens on national economies and individual families due to costs arising from acute and chronic morbidity and mortality. Globally, 2 billion people are infected with hepatitis B virus [HBV]. An estimated 170 million persons are chronically infected with hepatitis C virus [HCV] and 3-4 million persons are newly infected each year. Transmission of hepatitis B and C through infected needles, blades, etc. is well known. Barbers are the important parts of community, as almost every man needs at least monthly visit to barber for hair dressing or shaving. In Pakistan the prevalence of shaving by barbers is reported to be as high as 34%-49% of the male population and it is important to know how barbers perceive the risks in relation to prevention of transmission of hepatitis B and C. To assess the knowledge and attitude of barbers regarding HBV and HCV and find out practices among barbers which may be responsible for transmission of HBV and HCV. Cross-Sectional Study. This study was carried out in the Larkana city during the months of March 2010 to April 2012. A list of the barbers was obtained from the union of barbers and sample was drawn from that sampling frame. There were 422 barbers shops in the city. For sampling purpose Larkana city was arbitrarily divided into five zones [East, West, Central, South and North] and then 10 shops randomly selected from each zone. There were 156 barbers available and eligible for interview. After informed verbal consent, 132 barbers agreed to participate in the study. Data was entered, analyzed by Statistical Program for Social Sciences [SPSS] version 13. A total 132 barbers were interviewed. The mean age of respondents was 28 +/- 10 years, mean years of experience in barbering was 12.7 +/- 10. More than half [63.6%] respondents were married. Majority of the respondents [84.8%] were resident of urban areas. 64% barbers have had knowledge that hepatitis B and C can be transmitted through blood transfusion and sexual contact. Only 6.1% had been vaccinated against the hepatitis B. 70% of the barbers disposed of used blades in regular garbage. 82% washed hands before and after shaving each client, 92.4% cleaned their instruments with disinfectant after shaving the, 99.2% barbers change the blade for each client. The knowledge of barbers regarding the transmission of hepatitis B and C was fairly good but majority of the barbers were not vaccinated against Hepatitis B though they were knew that vaccine is available against the hepatitis B

Hydatid cyst of unusual sites, an experience at Chandka medical college Larkana

Hydatid cyst occurs throughout world but more in endemic areas where human beings live in close contact with cattle and dogs. Common organs affected by hydatid cyst are liver and lung but rarely occurs in other organs as well. To evaluate the unusual sites of hydatid cyst in human beings, this will help the clinicians in early diagnosis and management. Observational. The study was conducted in the Department of Pathology, Chandka Medical College Larkana from January 1995 to December 2009. Total of 191 patients, admitted in various hospitals of Larkana, and operated for hydatid cyst or incidental findings at hisptopatholgical examination were included. All the fixed biopsies were cut into representative tissue blocks, processed, stained for haematoxylin and eosin and examined under light microscope. Total of 191 cases of hydatid cyst were received in 15 years, out of which 119 [62.3%] cases occurred in liver with mean age 41.27 years +/- 16.27 SD, 44 [23%] in lung with mean age 44.04 +/- 15.81 SD and remaining 28 [14.7%] in other uncommon organs. The presence of hydatid cyst in uncommon sites in Larkana is 14.7%, hence possibility of hydatid cyst in almost every organ of the body should be suspected

Cause of death in exhumed bodies: an experience in upper Sindh, Pakistan

Exhumation is conducted around the globe when foul play is suspected. In developed world and in some developing countries this procedure is also carried out for identification purposes as well as in insurance claims, and some other civil suits. To determine the cause of death in exhumed bodies. Prospective, descriptive. The Study was conducted in the department of Forensic Medicine, Chandka Medical College, Larkana [CMCL] from Jan:2001 to Dec:2010. A total of 125 bodies were exhumed in various districts of upper Sindh by exhumation board, constituted by Director General Health Services Hyderabad. At the site of graveyard, bodies were digged out. After identification of deceased by near relatives, the bodies were thoroughly examined, viscerae taken for histopathological and chemical analysis, and cause of death determined by consensus in almost all cases. The most common cause of death was firearm injuries 37 [29.6%], followed by blunt trauma 15 [12%], sharp weapon injuries 09 [7.2%], drowning 09 [7.2%], poisoning 07 [5.6%] strangulation 06 [4.8%], infanticide 06 [4.8%]. In about 1/3 of cases cause of death could not be decided due to advanced stage of decomposition. Majority of victims were young males and firearm injury was the commonest cause of death

Pattern of haemotological disorders diagnosed by bone marrow examination at a paediatric hospital in Larkana Pakistan

Bone marrow examination is an integral part for establishing the diagnosis of haematological disorders in association with clinical and other routine laboratory tests. To evaluate the frequency and pattern of haematological disorders in children at a tertiary care hospital in Larkana. Descriptive study. The study was conducted at children hospital and pathology department of Chandka Medical College Larkana from Jan: 2008 to Dec: 2010. Marrow aspirates were collected from children under the age of 15 years as per guidelines recommended by international council for standardization in haematology [ICSH]. Smears obtained were stained with Romanowsky stains and examined under light microscope. Bone marrow examination reports of 271 patients ranged from 2 months to 15 years, with male /female ratio of 1.6:1 were analyzed. Malignant disorders were seen in 36.5% and non malignant disorders in 59.8% of ratio 1.6:1 were analyzed. Malignant disorders were seen in 36.5% and non malignant disorders in 59.8% of children. Amongst the malignant haematological disorders, acute lymphoblastic leukaemia [ALL] cases were 64 [23.65] and was found to be most common disorder, followed by lymphoma 7 [2.6%] cases and acute myeloid leukaemia [AML] 6 cases [2.2%]. In non malignant disorder, aplastic anaemia was the most common 40 [14.8%] cases, followed by iron deficiency anaemia 30 [11%] cases. The megaloblastic anaemia was least common seen only in 8 [3.0%] cases. Other non malignant disorders were idiopathic thrombocytopenic purpura [ITP] 71 [26.2%] cases and malaria 4 [1.5%] cases. Appropriate diagnosis can not be made in haemotological disorders of childhood without bone marrow examination

Exhumation -a key to provide justice to victims of homicide: situation in Larkana and Sukkur divisions

Foul play in cases of hurt and homicide is an established fact. People on basis of enmity falsely charge their enemies; this practice is carried out globally. The purpose of present study was to know the situation in the study area and also to know the risk factors which make hindrance in providing justice in exhumed cases. The present study was conducted over a period of 3 and half years from Jul 2006 to Dec 2009. During the said period total 21 exhumations were carried out in Sukkur and Larkana Divisions by the team of Chandka Medical College, Larkana. Cases were studied in Forensic Medicine Department of Chandka Medical College, Larkana. Out of 21 cases, only 9 cases were positive [autopsy]. In rest of 12 cases, autopsy reports remained undetermined due to advanced decomposition/putrefaction of corpses. During the study period, total 21 exhumations [autopsies] were carried out in different districts of Larkana and Sukkur divisions. There were 17 male cases and 4 female cases. Cases were divided in to 4 groups on age basis. Group-1 from 0-5 years, Group-2 from 16-30 years, Group-3 from 31-45 years, Group-4 from 46-65 years. The maximum number of cases fall in group-2 which are 15 [71.42%] and minimum in group-1 which is 1 [4.76%]. Out of 21 cases, only in 9 cases cause of death was ascertained and majority of these were firearm injuries [5, 55.55%], two [22.22%] cases of drowning, one [11.11%] strangulation and one blunt trauma. The success rate remained 42.85%. Nineteen cases were of primary autopsy [First time] on exhumation and 2 cases were secondary [re-examination]. The success rate in challenge cases depends mostly on the duration of exhumation and soil of cemetery. If a foul play is suspected then there should be no unnecessary delay in conduction of exhumation. If exhumation is carried out within days after burial, 90% results can be achieved