[131]I-MIBG on diagnostic and therapeutic frontiers in extra-adrenal abdominal paragangliomas: a case report with mini review

Paraganglioma are tumors originating from paraganglial system and may be associated with parasympathetic [head, neck and anterior mediastinum tumors] or sympathetic [adrenal or extraadrenal or posterior mediastinal tumor] system. Majority of sympathetic paraganglioma and minority of parasympathetic tumor are functional and [131I or [132]I labeled MIBG [Meta Iodio Benzyl Guanidine] is a well established tool with good sensitivity and exceedingly high specificity. We are presenting a case report of a large extradrenal paraganglioma with extensive bony metastases and raised serum Chromogranin-A level. In this case [131]-MIBG was not only helpful in revealing the true burden of functional disease but also showed an overwhelming therapeutic response proven on post-therapy MIBG scan and normalization of serum Chromogranin-A level. This case report is followed by a mini-review about pathology, genetic mutation, diagnosis and treatment of focused on extraadrenal paragangliomas

Isolated metastatic involvement of sternum in breast cancer: a case report with mini review

Solitary metastasis involving sternum in breast cancer is very uncommon and less is known about the possible mechanism. Similarly, clinical significance of this uncommon presentation is elusive. We are presenting a case of breast cancer with isolated sternal metastasis on radionuclide bone scan which was also documented on chest CT study. In this mini-review we will be discussing the possible mechanisms for isolated sternal metastasis in breast cancer, its clinical significance and therapeutic approaches used

Knowledge and perceptions of diabetes in urban and semi urban population of Peshawar, Pakistan

Diabetes mellitus is a major health issue in Pakistan. The aim of this study was to evaluate the knowledge and perceptions of diabetes in a sample population of Peshawar. This crosssectional, descriptive study was carried out in seven different localities of Peshawar. A sample of 305 residents were interviewed aged from 15-60 years and above, using a questionnaire specifically designed and translated into Urdu language for convenience of selected subjects. Knowledge of diabetes was suboptimal. The mean percentages of correct responses to questions regarding three classical symptoms and given complications were 47.1% and 30.8%. Excessive sugar intake, obesity, family history, lack of physical activities and stress were acknowledged by 46.2%, 42.3%, 39.3%, 33.4%, and 31.8% of the subjects respectively. Presence of family history and level of education were recognised to be associated with more knowledge. There is lack of awareness of major risk factors and some complications of diabetes mellitus. Level of education is a significant predictor regarding knowledge of diabetes and its prevention. Prevalence of diabetes has increased in Pakistan.

Biofilm formation and isolation of Staphylococcus aureus from blood cultures of dental patients undergoing oral surgical procedures

The objective of this study was the detection and separation of S. aureus from blood cultures of patients undergoing oral surgical procedures. Antibiotic sensitivity pattern and biofilm formation of S. aureus were also performed. Total 250 patients undergoing oral surgical procedures were selected for bacteriological examination. 5ml of Blood sample was collected in blood culture bottles containing tryptone soya broth. Blood sample was incubated at 37[degree sign] C for 7 days and after incubation subculturing was done on appropriate Media. The plates were then incubated at 37[degree sign]C aerobically for 24 hours, after which isolated colonies were obtained. S.aureus was identified by Gram staining, colony morphology, pigment production, catalase, coagulase and often biochemical tests. Antibiotic susceptibility was performed by disc diffusion technique on isosensitivity agar. Strains of S.aureus were used for biofilm formation by simple tubemethod. With the help of spectrophotometer at 570 nm optical density was measured. S.aureus [ATTC2523] was analyzed for biofilm production. Bacterial isolates in descending order were S.aureus 56%, E.coli 25%, Pseudomonas spp. 13%, S.typhi 4%and Shigella spp2%. S.aureus was resistant to different antibiotics. Biofilm production of S.aureus was detected in 16.17%of the S.aureus and mostly in association with antibiotic resistant bacteria. S.aureus was the predominant group of bacteria isolated from blood cultures of dental patients. Increased antibiotic resistance of S.aureus may be due to biofilm production resulting in persistent dental infections

simplified examination for detecting dental caries, plaque, gingivitis and calculus in school children-A longitudinal study

The objective of the present study was to compare longitudinally the simplified dental examination involving the use of a wooden spatula and a tooth pick with the conventional dental mirror and probe examination for the detection of cavitated carious lesions, dental plaque [with and without gingival bleeding] and calculus. This was a quasi-experimental study that involved 632 children having a mean age of 10 4 years at the start of the study and studying in eight different secondary schools of Karachi, Pakistan The children were subjected to two types of dental examination on three occasions with intervals of six and twelve months in between to detect cavitated carious lesions, dental plaque [with and without gingival bleeding] and calculus. All examinations were conducted by a single examiner who was trained and calibrated for both types of examination. One type of examination involved the use of a wooden spatula and a toothpick [TS examination] while the other type was carried out using the plain mouth mirror and CPI [Community Periodontal Index] probe [MP Examination]. All examinations were performed under identical conditions using natural light Teeth' and 'sextants of oral cavity' were considered as the units of measurement for data analysis. The WHO recommended criteria for decayed, missing and filled teeth were followed for caries detection. A dichotomous scale was used for plaque [with and without gingival bleeding] and calculus with 'present' or 'absent categories. The sensitivity of TS examination for detecting cavitated carious lesions in three examinations ranged from 88.35% to 90.86%; and for Plaque [with and without bleeding] and calculus from 92-99%, the lowest value being for 'calculus' and the highest for 'plaq 1 ue with bleeding' The specificity, positive predictive value and negative predictive value were between 98-99% for both caries and the three components of oral hygiene status, The TS examination can provide a desirable substitute to conventional MP examination in order to undertake regular dental check-ups of school children including detection of cavitated various lesions and assessment of oral hygiene status

role of essential oils in periodontal health: an appraisal of evidence

The objective of this search was to find out "Do essential oils as a therapeutic agent assist in maintenance of periodontal health?" The article is based on a search which was conducted on Medline to identify the studies related to the topic and published up to Sep 2008. Fifty nine articles were retrieved from the search. Four articles were in languages other than English which have not been included in the appraisal. Thirty two articles had information relevant to the search question. Based on the finding of the search it is concluded that essential oil when used as an adjunct to unsupervised oral hygiene can provide additional benefit in reduction of plaque and gingivitis

Bone scan: a sensitive modality for diagnosing and predicting outcome for reflex sympathetic dystrophy

Reflex sympathetic dystrophy is a consequence of overactive sympathetic nervous system that results in burning pain, stiffness, swelling and discoloration of the affected limb. This case report describes the condition in a man that was diagnosed with the help of radionuclide bone scan

Caries status among children aged 12-16 in 4 districts of Karachi

Owing to the global problem of dental caries and its marked variation among children of different socio-economic groups, we have conducted a survey and data collection of 800 school children of Karachi city divided into 4 districts i.e. South, West, East and Central. Socio-economic status is a valuable measure in many health studies because it is so closely correlated with many health related characteristics. Attitudes toward health are often part of the set of values that follow from an individual's prestige in society and may explain some of the observed differences in health between socio-economic groups