clinico-pathological study of oral cancers

In many Asian cultures where chewing betel, paan and areca is common, oral cancer represents up to 40% of all cancers. It may arise as a primary lesion originating in any of the oral tissues, by metastasis from a distant site of origin, or by extension from a neighboring anatomical structure. A tissue biopsy and microscopic examination of the lesion confirms the diagnosis and malignancy of oral cancer. To see the clinical and histopathological pattern of oral cancer. This was a retrospective case series studies carried out at Histopathology Department of PNS Shifa Hospital, Karachi. Detailed clinical histories of the patients were recorded and their histopathology was performed using haematoxylin and eosin [H and E] stain. Clinical data collected included the age, sex of patient and intra-oral site of cancer. Histopathological data included type of cancers and their degree of differentiation. The inference was drawn from this record. The data was analysed on SPSS version 17. A total of 268 oral mucosal biopsy reports were studied which constituted 6.6% of all malignant tumours reported during this period. Among the 268 cases studied, 256 [95.5%] cases were of squamous cell carcinoma [SCC], 4 [1.5%] were of basal cell carcinoma [BCC] and 2 [0.75%] each were of adenoid cystic carcinoma, mucoepidermoid carcinoma, adenocarcinoma and undifferentiated carcinoma. amongst the SCC group, 116 [43.28%] cases were well differentiated, 128 [47.76%] cases were moderately differentiated and 16 [5.97%] cases were poorly differentiated. Tongue was the commonest site involved in 116 [44%] cases followed by buccal mucosa 88 [33.3%] cases. Squamous cell carcinoma is the predominant type of oral cancer and tongue is the commonest site of origin for these cancers. In our patients oral cancer presented at a relatively early age group

clinicopathological study of urethritis in males

To determine the etiology and frequency of different types of urethritis in adult males. A case series. The Dermatology Department of PNS Shifa Hospital, Karachi, from June 2004 to December 2007. One hundred male patients having complaints of urethral discharge and dysuria reporting in the skin OPD were included in the study. Patients who had received systemic treatment for their complaints and those who had other systemic infections were excluded. A detailed history including history of sexual contact was taken. Dermatological examination including examination of external genitalia was also performed. All these patients were subjected to complete physical examination, complete urine examination, urethral pus for gram staining and culture, endo-urethral swab with urethral loop for seeing Chlamydia antigen by fluorescent microscopy, cultures for ureaplasma and Wet mount specimen microscopy for trichomonas along with HIV [serum ELISA] test. Non-gonococcal urethritis was diagnosed on the presence of more than five polymorphonuclear leucocytes per high power field in at least five fields of Gram stained urethral smear, in the absence of Gram negative diplococci. The mean age was 29.2 +/- 5.8 years. Seventy [70%] cases were diagnosed as gonococcal urethritis and 30 [30%] cases as non-gonococcal urethritis [NGU]. History of illicit sexual exposure was available in 25 [25%] patients. The interval period between initiation of symptoms and reporting of patient in gonococcal urethritis was 4 to 30 days [mean 12.8 days] and 4 days to 2 months [mean 20.7 days] in non-gonococcal urethritis. The patients with gonococcal urethritis presented with purulent discharge in 66 [84%] cases, and dysuria in 49 [70%] cases. In the NGU group, 25 [80%] cases had mucoid discharge and 18 [65%] had dysuria. in 70%, Neisseria gonorrhoeae was isolated, Chlamydia trachomatis in 16%, ureaplasma in 8%, and Trichomonas vaginalis in 4%. No organism could be detected in 2% cases. HIV test was negative in all cases. Gonococcal urethritis was the commonest urethritis seen followed by Chlamydia infection in the studied group of adult males

Treatment of nail psoriasis with amodified regimen of steroid injections

To evaluate the efficacy of a modified regimen of intralesional steroid injection therapy for the treatment of nail psoriasis and assess the side effects of this regimen. Quasi-experimental study. Dermatology Department of Military Hospital, Rawalpindi, from February 1999 to January 2001. Patients having psoriatic nail dystrophy, reporting to the skin department of Military Hospital, Rawalpindi were registered. The features accounted for were pitting, onycholysis, subungual hyperkeratosis, ridging, thickening and color change. The affected digits were scored from 0 to 3 for the severity of each of these features. Similar number of control digits was also selected. Injection of triamcinolone acetonide [10 mg/ml] was given into the nail bed and matrix following ring block anesthesia. The features were re-scored after two months. A second injection was given after 02 months if warranted by poor response. The follow-up period ranged upto 06 months. A total of 100 nails were injected in 35 subjects. Pitting was the commonest presenting feature seen in 71 digits [71%] and improved in 41 digits [57.7%]. Onycholysis was seen in 37 digits [37%] and improved in 15 digits [40.5%]. Subungual hyperkeratosis was seen in 57 digits [57%] and improved in all the cases. Other features like longitudinal ridging, thickening and yellow oil drop-like discoloration showed marked improvement. The side effects of this regimen were minimal and included painless subungual hematoma. The modified regimen of steroid was found to be effective and safe for the treatment of psoriatic nail deformities in this series

Skin lesions in hospitalized cases of dengue fever

To determine the frequency and types of skin lesions in cases of dengue fever in patients admitted in three hospitals of Karachi. Case series. Three tertiary care hospitals of Karachi, from November 2006 to February 2007. One hundred patients of dengue fever with positive anti-dengue Immunoglobulin M [IgM] serology were included in the study. The admitted patients in PNS Shifa Hospital, Jinnah Postgraduate Medical Centre [JPMC] and Civil Hospital, Karachi were selected for the study. Presenting features were noted. The patients were physically examined for the presence of skin and mucosal lesions and findings were recorded. Total and Differential Leukocyte Count [TLC and DLC], platelet count and Liver Function Tests [LFTs] were done in all the patients. All the patients had low leukocyte and low platelet counts. The common presenting symptoms were high-grade fever with or without rigors, headache, body aches, backache, vomiting, sore throat with cough and generalized weakness [seen in 86% patients]. The uncommon presenting features were diarrhea, abdominal pain, bleeding from gums and nosebleeds [seen in 14% patients]. Sixty-eight [68%] patients had skin lesions. The most common skin presentation was generalized macular blanchable erythema involving trunk and limbs, seen in 44 [65%] cases. Discrete petechial lesions were seen on various body areas in 24 [35%] cases. Palmer erythema was seen in 20 [30%] patients. Generalized itching was seen in 16 [23%] cases. Isolated itching of palms and soles was seen in 20 [30%] cases. Twenty-eight [28%] patients had deranged LFTs. Out of those, 4 patients had raised serum bilirubin level whereas rest of the 24 had raised ALT Dengue fever commonly presents with specific skin lesions. The skin lesions can be a clue to the diagnosis in difficult cases

Evaluation of a simplified protocol of steroid injections for nail psoriasis

To evaluate the efficacy of a modified regimen of intralesional steroid injection therapy for the treatment of nail psoriasis and to assess the side effects of this regimen. Quasi-experimental study. Dermatology department of Military Hospital Rawalpindi from Feb 1999 to Jan 2001. Patients having psoriatic nail dystrophy, reporting in skin department of Military Hospital Rawalpindi were registered. The features accounted for were pitting, onycholysis, subungual hyperkeratosis, ridging, thickening and color change. Injection of Triamcinolone acetenoid [10mg/ml] was given into the nail bed and matrix following ring block anesthesia. A second injection was given after 02 months if warranted by poor response. The follow up period ranged upto 06 months. Eighty three digits were injected in 35 subjects. Pitting was the commonest presenting feature seen in 71 [85.5%] digits and improved in 51 [71.8%] digits. Onycholysis was seen in 37 [44.6%] digits and improved in 25 [67.6%] digits. Subungual hyperkeratosis was seen in 57 [68.7%] digits and improved in all cases. Other features like longitudinal ridging, thickening and yellow oil drop like discoloration also improved considerably. The side effects of this regimen were minimal. This regimen has been found to be effective and safe for the treatment of psoriatic nail dystrophy