Hepatitis b [HBV] and hepatitis c virus [HCV]; frequency of risk factors

Infections with Hepatitis B Virus [HBV] and Hepatitis C virus [HCV] are worldwide public health problem. This is related to the continued occurrence of new infections and the presence of a large reservoir of chronically infected persons. To determine the frequency of risk factors [causes of transmission] for HBV and HCV infections in hospitalized patients of CMH, Lahore and Sheikh Zayed hospital, Lahore. Design: Descriptive [cross sectional]. Setting: The study was carried out in CMH, Lahore and Sheikh Zayed hospital, Lahore from January, 2012 to July, 2012. The patients were selected by consecutive [non-probability] sampling technique. The data was collected through questionnaire. Informed written consent was obtained SPSS version 16.0 was used to calculate the descriptive statistics. Out of total of 100 subjects, 50 were cases and 50 were controls. Out of 50 cases, 26% were HBV positive and 74% were HCV positive with female preponderance. The history of injections was very high in both the groups, making a total of 64% [14% HBV; 16% HCV] the important contributors for different types of hepatitis were blood transfusion [HBV = 10%; HCV = 28%; controls = 14%]. Surgical procedures [4% HBV, 28% HCV; 8% controls]. History of piercing in the last six months [HBV = 6%; HCV = 22% and control = 8%]. History of dental procedures in the last six months was higher in HCV patients [18% HCV and 4% HBV]. History of HBV or HCV positive patients or relatives at home. [HBV 18%; HCV 36%; control 30%]. Conclusions: In Pakistan there is an urgent need to raise the public awareness about importance of properly screened blood transfusion, use of disposable needles and using new blades for shaving and haircuts especially at barber shops. In our study, the important contributors for different types of hepatitis were blood transfusion, surgical procedures and history piercing in the last 6months

Haim Munk syndrome: two siblings of southern Pakistan treated with acitretin

Haim Munk Syndrome [HMS] is an extremely rare autosomal recessive disorder with the allelic mutation of exon 6 codon in cathepsin C gene. It is characterized clinically by palmo-plantar keratoderma [PPK], aggressive early onset of periodontitis, onychogryphosis, arachnodactyly, acro-osteolysis and pes planus. This study presents two cases of the same family with HMS having almost all the cardinal features of this rare disorder. Both the siblings were treated with acitretin, co-trimoxazole and topical keratolytics and followed up for 6 months

Association of Helicobacter pylori with colorectal cancer development.

Background: Helicobacter pylori (H. pylori) may be associated with colorectal cancer. However, the underlying mechanisms are still unclear. Objectives: Explore the serostatus of H. pylori cytotoxicity-associated gene A product (CagA) in patients with colorectal carcinoma, and assess the association of H. pylori with colorectal cancer via c-Myc and MUC-2 proteins at tumor tissues. Methods: H. pylori CagA IgG antibodies were screened using enzyme-linked immunosorbent assay (ELISA) in 30 patients with colorectal carcinoma and 30 cancer-free control subjects. Paraffin-embedded blocks were examined for the expression of c-Myc and MUC-2 protein by immunohistochemistry. Results: H. pylori CagA seropositivity increased significantly among colorectal cancer patients (p <0.05). The expression of c-Myc and MUC-2 in colorectal carcinoma patients was over-expressed (80%), and downexpressed (63%) in resection margins (p <0.05). c-Myc over-expression and MUC-2 down-expression were associated with CagA-positive rather than CagA-negative H. pylori patients. In 16 CagA seropositive vs. 14 CagA seronegative patients, the expression rate was 97.3% vs. 64.2% and 33.3% vs. 78.5% for cMyc and MUC-2, respectively. CagA IgG level was significantly higher in positive than in negative c-Myc patients (p= 0.036), and in negative than in positive MUC-2 patients (p= 0.044). c-Myc and MUC-2 were positively and inversely correlated with CagA IgG level (p <0.05). Conclusions: CagA-seropositive H. pylori is most probably associated with colorectal cancer development. Part of the underlying mechanism for such association might be via alterations in expression of MUC-2, which depletes the mucous protective layer in the colo-rectum, and c-Myc, which stimulates the growth of cancerous cells.