Nonalcoholic fatty liver disease in nonworking / dependent class using ultrasonography and liver function tests: as a cost effective tool

Objective: To evaluate utility of gray scale abdominal ultrasound and liver function tests in the prevalence of Nonalcoholic Fatty Liver Disease in non-working / dependent class of Faisalabad

Study Design: Screening study

Setting: Department of Radiology Allied Hospital, Faisalabad

Duration of Study: 6 months, from December 1 2012 to July 2013

Sample Size: 300. Study Participants -Demographics

Material and Methods: Patients, who denied regular alcohol drinking, were included in the study. A pre-designed study pro forma was filled with relevant parameters i.e. body mass index [BMI], ultrasound, and LFT, s, WHR, lipid profile, clinical assessments were carried out in all cases along with real-time gray scale abdominal ultrasonography as established diagnostic tool. We compared the results of LFT, s and hepatic ultrasound of suspected and non-suspected and are statistically analyzed by SPSS 12

Results: Out of three hundred patients, 200 [67%] female and 100 [33%] were male suspected. Mean age of the patients was 38.93 +/- 8.57 years. The prevalence of fatty liver in males younger than 35 years old was significantly higher [71.7%] where as it markedly increased in females younger than 48 years [65.25%]. Multiple factors analysis reveals that the prevalence of fatty liver was positively correlated to several risk factors, including female, age [>50yr], hyperlipidemia, impaired glucose tolerance/diabetes mellitus, hypertension and overweight/obesity. Fifty one [54%] patients with symptoms like obesiy, fatigue, generalized, weakness, and pain RUQ had fatty liver where as 23.2% had raised Liver enzymes, 20.0% with cholelithiasis and 16.92% with D.M

Conclusions: Routine hepatic ultrasonography and LFT in every suspected patient with symptoms of fatigue, generalized weakness, and pain in RUQ, is able to detect NAFLD as it is cheap and easily available facility in our country

Soft tissue analysis in Class I and Class II skeletal malocclusions in patients reporting to Department of Orthodontics, Khyber College of Dentistry, Peshawar

The main objective of this research was to analyze soft tissue paradigm of patients with Skeletal Class I and Class II malocclusions in adult male and female groups of patients reporting to Department of Orthodontics, Khyber College of Dentistry. In the present study 100 patients were selected, 50 of Class I and 50 of Class II with equal gender distribution in both classes having age range of 15 -30 years. Soft tissue interpretation was done by cephalometry. The results show more convex profile among Class II patients. Both upper and lower lips were anteriorly positioned. No gender variability was found regarding nasolabialangle, Z- angle and Ricketts E-line. The review study reveals that different races have their own norms which provide helpful guide-lines in formulating the treatment plan

Isolation and characterization of irritant components of Euphorbia pilulifera L.

Euphorbia pilulifera is commonly found weed along road sides and loamy soils. This weed is commonly used as treatment of female disorders and respiratory problems. The latex of this weed causes irritation on hand on contact. To evaluate its irritant potentials, the dermatological investigation of irritant principles from locally occurring Euphorbia pilulifera was carried out. For this purpose, after collection and drying, a series of solvents with increasing polarity were used for the successive extraction of non-polar compounds [petroleum ether extract], constituents of intermediate polarities [chloroform extract] and polar constituents [methanol extract] from the whole herb of Euphorbia pilulifera. The chloroform extract of this weed was found most irritant to rabbit's skin. Chloroform extract was further subjected to column chromatography; four fractions Ep 1 to Ep 4 were isolated from active chloroform extract by column and thin layer chromatography. The irritant potentials of these isolated fractions were evaluated on rabbit's skin. Two fractions out of the four, Ep 1 and Ep 3 appeared to be the most irritant than others. A possible structure activity relationship of these active compounds was discussed in order to establish their activity

Malrotation of gut with horse shoe kidney

We report case of malrotation of gut with horse shoe kidney. Plain abdominal x ray reveals no pneumoperitoneum, abnormal calcification, and abnormal gut loop seen. Where as on barium study, small gut situated in right side of abdomen with ileo-cecal junction located in Left iliac fossa. Complementary gray scale ultrasound done, no gut mass/dilatation, vicero-megaly appreciated however it showed horse shoe kidney. CT showed also horse shoe kidney

Open prostatectomy

To study the morbidity of open prostatectomy. To assess the frequency of complications after open prostatectomy. Descriptive cross sectional. Surgical Unit-IV, DHQ Hospital, Faisalabad. 01-01-2003 to 31-12-2003 [One Year]. Patients of bladder outlet obstruction due to benign prostatic hyperplasia [PBH] were operated by open surgery [Transvesical or retropubic prostatectomy]. Open prostatectomy was performed in 54 cases. In 38 cases, suprapubic transvesical prostatectomy was performed, while in 6 cases, retropubic prostatectomy was done. Our youngest patient was 42 years old and oldest 90 years. Mean age was 62 years. In our study, the most common complications were wound associated seen in 7[12.96%] cases. They included cellulites in 3[5.56%] cases, stitch abscess in 1[1.85%] cases, seroma in 1[1.85%] cases, and abscess in 2[3.70%] cases. Other complications were bleeding in the form of reactionary haemorrhage/clot retention in 2[3.70%] cases and secondary haemorrhage in 3[5.56%] cases. Urinary fistula was seen in 5[9.26%] cases while retrograde ejaculation in 6[11.11%] cases, stricture urethra in 3[5.56%] cases, urinary incontinence in 4[7.41%] cases and urinary tract infection in 5[9.26%] cases. Epididimo-orchitis, deep vein thrombosis and osteitis pubis were not seen in our study. The average duration of hospital stay was 6 days. Most cases were discharged within five days of operation, while stitches were removed on the eighth postoperative day. The morbidity of open prostatectomy is higher than transurethral resection [TURF], as TURP is better procedure due to lower complication rate, short hospital stay, cost effectiveness and better tolerated by old and unfit patients, presenting with small fibrotic prostate. Open prostatectomy is still a good option for BPH where TURP facilities are not available

Leukoplakia of oral cavity; study in population of Karachi

To observe the various histological types of lesions in order to evaluate the different sites involved and correlate the lesions with tobacco use. SETTING: Dental Department of Jinnah Postgraduate Medical Centre Karachi. METHODS: Biopsies from 75 clinically diagnosed patients were examined after staining them with haemotoxylin and Eosin, Masson Trichrome, Periodic Acid Schiff reagent, Reticulin and Grocott Gomori stains. N 38 were males and 37 were females. Maximum number of patients suffering from Leukoplakia were in their fifth and sixth decades with a slight male preponderance. Mixed habits were found in majority of the patients with buccal mucosa being the dominant site. Every white lesion of the oral cavity must be thoroughly investigated as it could result from a simple hyperplastic epithelium up to a frank carcinoma

Cerebral Venous Thrombosis.

Eleven patient (3 males and 8 females ) in the age group 19-49 ( men 29 years ), were diagnosed to have aseptic cerebral venous thrombosis over a period of four years. The presenting features were headache (11), papilledema (9), vomiting ( 6 ), altered consiousness (4 ), hemiparesis (4 ), generalized seizures (3) focal seizures (2 ), hemianesthesia (1 ) and buzzing in the ears in 1 patient. Diagnosis was established by cranial CT scan, MRI and MR Angiography Predisposing factors identified in these patients were puerperal state (5 ), pregnancy and another patient had familial antithrombin III deficiency. All patients were treated with heparin and warfarin. In addition anticonvulsants and anticerebral edema measure were used wehn necessary, Eight patients completely recovered; one patient with Beheet's synodrome and retinal vasulitis had severe visual loss ; one had residual hemiparesis and one optic atrophy.

Psychosocial adjustment after renal transplantation

Renal Transplantation is fairly new in our country and is expected to be the only satisfactory long-term treatment for patients with End Stage Renal Disease. Such treatment offers them a chance for near normal life. Seventeen patients who underwent kidney transplant during 1987-88 at the department of Nephrourology of J.P.M.C. Karachi, were reviewed. The result of ten patients who were assessed for their psychosocial adaptation is presented