Relationship between recurrent Laryngeal nerve [RLN] and inferior Thyroid artery [ITA] in our population

Objectives: To find out the relationship between recurrent laryngeal nerve[s] [RLN] and inferior thyroid artery [ITA] in patients undergoing thyroid surgery in our population

Study Design: Descriptive, cross-sectional study

Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi and Combined Military Hospital Rawalpindi from Aug 2008 to Dec 2014

Material; and Methods: One hundred recurrent laryngeal nerves, 50 right and 50 left were studied in 64 patients. All cases of benign goiter, malignant T1, T2 goiter, completion thyroidectomy cases on virgin side were included. Malignant T3, T4 cases, redo surgery, and large multi nodular goiter, cases in which posterior nodules have displaced the nerve [s] were excluded from the study. The course of the nerve was dissected in the thyroid vicinity and its relation with the inferior thyroid artery was recorded and photographed. All the data and special points were noted by the surgeons themselves in a register in all the cases and photographs were also taken. The data was entered and analyzed using statistical package for social sciences [SPSS] version 16. A p-value of <0.05 was considered significant

Results: Hundred RLN were studied in 64 patients. In 36 patient RLN on both sides and in 14 patients the right and in 14 patients the left RLN were studied. The age ranged from 15-65 years with mean age 36.4 years. Male to female ratio was, 1: 4.3. Percentage of male patients was 18.75 percent as compared to female was 81.25 percent. In our study the nerve was more commonly found passing posterior to inferior thyroid artery on both sides and in both sexes. On the right side it was seen in 60 percent of cases and on the left side it was seen in 70 percent of the cases

Conclusion: Relationship of RLN with ITA is variable in our population. The surgeon should be aware of these variations and meticulous dissection of RLN is mandatory in tumor surgery and redoes thyroid surgery to avoid injury to these nerves

The complete clinical response in rectal Carcinoma after Chemo radiation

Objective: To determine the complete clinical response in rectal carcinoma after neoadjuvant chemo radiation

Study Design: Cross-sectional study

Place and Duration of Study: This study was conducted in Clinical Oncology department, Jinnah Postgraduate Medical Centre Karachi, from Jan 2016 to Jan 2017

Material and Methods: Seventy Two Patients meeting the inclusion criteria were enrolled in study after complete staging workup. Neoadjuvant concurrent chemoradiotherapy was planned, consisting of oral capecitabine 825mg/m2 BID five days a week along with 50.4 Gy Radiotherapy with linac machine. Radiation was delivered over a period of 5 weeks at a rate of 1.8 Gy/day. Patients received Radiotherapy in Atomic Energy Medical Centre [AEMC] and in Sindh Institute Urology and Transplant [SIUT], Radiation department. Chemotherapy was given in clinical oncology department of JPMC. Sixty one patients completed planned treatment and were available for post concomitant chemo radiotherapy response assessment with Pelvic CT/MRI after 6-8 weeks of completion of concomitant chemo radiotherapy. Response assessment was done according to Response Evaluation Criteria in solid tumor [RECIST] criteria version 1.1 and then Patients were referred for surgical evaluation

Result: A total of 61 cases of locally advanced adenocarcinoma rectal cancer patients were included in the study.Mean age of the patients was 41 years with +/- 17.06 years SD. Complete clinical response was identified in 4 [6.6 percent] while 31 [50.8 percent] were identified as partial response, progressive disease was 13 [21.3 percent] and 13 [21.3 percent] were with stable disease. All confounding variables were found statistically significant with p-value found less than 0.05

Conclusion: Neo-adjuvant chemoradiotherapy for locally advanced rectal cancer is associated with high rates of tumor response in terms of downs tagging [complete and partial] and is relatively safe with acceptable morbidity, which favors its use in future

Evaluation of single preoperative dose of Pregabalin in terms of Postoperative pain after Laparoscopic Cholecystectomy

Objective: Evaluation of single preoperative dose of pregabalin in terms of postoperative pain after laparoscopic cholecystectomy

Study Design: Randomized controlled trial [RCT]

Place and Duration of Study: Study was conducted in Surgical Department of Military Hospital Rawalpindi over a period of one year fromJan 2013 to Dec 2013

Material and Methods: One hundred patients [50 in each group] were included in this study. They were divided into two groups. Group-A was given pregabalin and group-B was given placeboafter laparoscopic cholecystectomy

Results: Mean age was 38.2 +/- 11.0 years in group A and 36.9 +/- 11.7 years in group B. Regarding distribution of gender, 14 patients [28.0 Percent] in group-A and 17 patients [34.0 Percent] in group-B were males while 36 patients [72.0 Percent] in group-A and 33 patients [66.0 Percent] in group-B were females. Mean visual analogue score at 24 hours was 4.98 +/- 1.87 and 6.58 +/- 2.03 in group-A and B, respectively. The difference between two group was statistically significant [p<0.001]. Analgesia was required in 17 patients [34.0 Percent] in group-A and 37 patients of group-B

Conclusion: A single preoperative oral dose of pregabalin 150 mg was found very effective method for reducing postoperative pain in patients undergoing laparoscopic cholecystectomy

Diagnostic accuracy of sonoelastography in the non-invasive diagnosis of malignant breast cancer compared to histopathology as a gold standard

Objective: To observe the diagnostic accuracy of elastography in detecting malignant breast lesion taking strain ratio of 4.8 and histopathology as gold standard

Study Design: Descriptive cross-sectional study

Place and Duration of Study: Department of Diagnostic Radiology, from March to September 2015

Methodology: A total of 137 patients aged 20 to 60 years with clinically palpable breast lump of any size for at least one month duration were included in this study. Patients with purely cystic lesions and those on chemotherapy or hormonal therapy were excluded. Each patient was subjected to sonoelastography followed by ultrasound guided trucut biopsy. The strain ratio cut off value of 4.8 was used to differentiate benign from malignant lesion. Consultant histopathologist's report upon the biopsy specimens was obtained. Results of sonoelastography were compared with histopathology reports

Results: Mean age was 38.20 +/- 10.63 years. The size of the lesion ranged from 2.0 to 6.0 cm, a mean = 3.97 +/- 1.26 cm. The duration since the lump was noticed ranged from 12 weeks [3 months] to 20 weeks [5 months] with a mean of 15.09 +/- 2.56 weeks. Forty-one [29.9%] lesions were labelled malignant on sonoelastography while the actual number of malignant lesions was 35 [25.5%] on histopathology. When the results of sonoelastography were cross-tabulated with histopathology results, the number of TP [true positive], FN [false negative], FP [false positive] and TN [True negative] were 31, 4, 10 and 92 cases, respectively. It yielded 88.57% sensitivity, 90.20% specificity, 75.61% positive predictive value, 95.83% negative predictive value, 89.78% accuracy for sonoelastography in the diagnosis of malignant breast lesion taking histopathology as gold standard with an observed prevalence of malignant breast mass to be 25.55%

Conclusion: Using a strain ratio of 4.8, sonoelastography was found to be 88.57% sensitive, 90.20% specific, and 89.78% accurate in the diagnosis of malignant breast masses

Bile duct injuries and outcomes: a retrospective medical record review

Objective: To report on our experience of cholecystectomy associated bile duct injuries and observe factors influencing outcomes

Study Design: Simple descriptive study

Place and Duration of Study: Surgical unit IV, Military Hospital [MH] Rawalpindi, over a period of seven years from 01-01-2005 to 1-12-2012

Material and Methods: Eighty eight patients who underwent repair of bile duct injuries during this period were included in this study. Patients referred from class 'W and 'C' hospitals to our institute were also included

Results: Fifteen immediate repairs [0-72 hours] post cholecystectomy, forty eight intermediate repairs [72hrs-6wks] and twenty five late repairs [> 6 wks] were performed [table-1]. Short term morbidity was higher in patients with upper biliary tract injury [p=.04].The most common long-term complication was biliary stricture, which occurred in 28 patients [31.8%]. Patients with bile duct injuries [BDIs] repaired in intermediate period were more prone to develop stricture of biliary tree than those repaired in immediate or late period [p=.03] [table 3]. Long term morbidity was also higher in patients who presented with bile contamination of peritoneum [p=.03] and had sustained complex biliary tract injuries [E4/E5] [p=.03].The overall morbidity and mortality rate was 31% and 3% respectively

Conclusion: We observed that complex hilar injury, presence of intra-abdominal bile and timing of BDI repair is an important predictor of long-term outcome. Injuries repaired in early [0-72hrs] or late period [>6wks] were less likely to develop biliary stricture as compared to injuries repaired in intermediate period [72hrs-6wks]. Moreover complex hilar injuries and intra-abdominal bile at presentation increases the possibility for development of late biliary stricture

Anxiety, depression and cognitive changes in patients on hemodialysis

To asses Anxiety, Depression and Cognitive changes in patients of chronic renal failure on hemodialysis. Cross-sectional descriptive study. Department of nephrology, Combined Military Hospital [CMH] Lahore from March to July 2010. Forty one patients at end stage renal disease on hemodialysis were selected from Nephrology department CMH Lahore. Written informed consent was obtained. Diagnostic instruments like Hospital Depression and Anxiety Scale [HAD Scale] Urdu version and Mini-Mental State Examination [MMSE] were used for data collection. The number of enrolled patients was 41 with age ranging between 50-70 years with 63.4% males. Results showed that out of 41 patients 7[17.1%] had mild anxiety, 7[17.1%] had severe anxiety while 27[65.9%] were normal. However, out of 41, 5[12.2%] had mild depression, 15[36.6%] had severe depression whereas 21 [51.2%] had no depression. MMSE scoring showed that, 5[12.2%] had mild, 4[9.8%] had moderate and 3 [7.3%] had severe cognitive changes, whereas 29[70.7%] patients had no cognitive changes. More than one third of the patients [37%] in this study were suffering from anxiety, depression and cognitive changes. Recognition of these problems in patients of chronic renal failure on hemodialysis is of fundamental importance in the management of patients. The quality of life can be improved in such patients with psychiatrist treatment

efficacy of steroids in the treatment of bronchiolitis

To determine the efficacy of steroids in the treatment of bronchiolitis. Study Design: Randomised Controlled Trial [RCT]. The Department of Paediatrics, Military Hospital, Rawalpindi and the Department of Paediatrics, PNS Shifa Hospital, Karachi for six months, from Feb 2006 to Aug 2006. Ninety patients of bronchiolitis were sampled and randomly divided into three groups. Each group was given the same treatment protocol differing only in the steroid given [Group I - intravenous Hydrocortisone, Group II - nebulised Beclomethasone, Group III - no steroids]. Data was compiled by means of a proforma. Outcomes were length of hospital stay [LOS], difference in clinical respiratory score [R], and time to become wheeze free [W]. Mean LOS was lowest in Group II [p = 0.259]. The mean duration to become wheeze free [W] was also lowest in Group II [p= 0.40]. The biggest improvement in Respiratory Distress Assessment Instrument [RDAI] score at admission and discharge [R] was in Group I and least improvement in Group II [p=0.056]. Corticosteroids are not significantly effective in reducing length of hospital stay, duration of wheezing and improvement in clinical severity. However, inhaled steroids may possibly have a potential advantage over parenteral steroids

Radionuclide gastroesophageal reflux scan; an effective screening tool for infants/children with repeated chest infections

Objective: unexplained recurrent chest infections are a cause of failure to thrive in infants and young children. Repeated hospital admissions with respiratory symptoms are an extra economic burden on the health budget along with the morbidity. The aim of this study was to analyze the utility of Nuclear Medicine to screen children with clinically significant gastroesophageal reflux

Design and Place of Study: this study was descriptive case series and was conducted at Punjab Institute of Nuclear Medicine in collaboration with the department of pediatrics Allied Hospital Faisalabad

Patients and Methods: seventy clinically symptomatic patients underwent Gastroesophageal Reflux [GER] Scan with effective fasting of one to three hours. Four to thirty seven MBq of [99m]Tc labeled Colloid was diluted in milk for oral intake. Thirty minutes dynamic study with frame rate of 3 second per frame was acquired in either anterior or posterior projection. Both qualitative and quantitative analysis was done using cine review, time active curves [TAC] and percentage reflux index [%RI]. Patients with high grades of reflux were also reviewed after 08 weeks of conventional antireflux treatment

Results: sixty three percent of the patients [44/70] were declared as reflux positive of varying grades on GER scan. Most of the refluxing subjects [26/44] were in grade I/II category while [13/44] of the patient showed moderate degree reflux and only [2/44] of the patients fell into severe reflux category. Chest infection was the chief clinical presentation in each grade of reflux [57%]. Of all the refluxing individuals, [9/44] were having no refluxing spikes on TACs while when reflux index [%RI] were calculated [4/44] of the patients showed value below 4%. Eighty percent of selected patients [8/10] showed improvement with conventional antireflux treatment but complete improvement was evident only in [3/10] patients

Conclusion: GER scan is a non-invasive and effective way of screening clinically symptomatic babies for reflux of the gastric contents interfering with the respiratory tract. Quantitative assessment of improvement after conventional antireflux treatment offer cost-effective follows up of GERD

Therapeutic role of zinc; evaluation in patients with diarrheal illnesses

To evaluate the efficacy of zinc supplementation in patients with diarrheal illnesses. Quasi Experimental study. The study was conducted at the pediatrics department of Madina Teaching Hospital, Sargodha road, Faisalabad, 6 months period from November 2008 to April 2009. Two hundred children suffering from diarrhea with mild to moderate dehydration were included in the study and divided into two groups, A and B. Group A was given zinc supplementation along with ORS and adequate nutrition according to age. In group B 100 children were taken as control to whom only ORS and adequate nutrition for age was given. Baseline clinical parameters were comparable in both groups at admission. The effect observed on stool consistency was more marked in 72 hours i.e. 71% patients were improved in group A versus 40% in group B, as compared to stool frequency in 72 hours i.e. 56% in group A versus 39% in group B. Although in 7 days, 99% patients showed improvement in stool consistency in group A, 70% in group B [p value 0.037] and stool frequency showed improvement of 96% in group A as compared to 77% in group B [p value 0.037]. Duration of hospital stay on the average was about 2 days less in case of zinc supplemented group as compared to control group. Zinc supplementation reduced the duration and severity of mild to moderate diarrheal illness and treatment was well tolerated with no significant side effects

Gall bladder carcinoma with krukenburg tumour a case report

To determine the mechanism and pattern of animal related injuries in the troops deployed in field. A hospital based observational study. Main Dressing Station Kotli Azad Kashmir from Jan 2004 to Jan 2006 An observational hospital based study was carried out on all the patients who reported to the Main Dressing Station [MDS] between Jan 2004 to Jan 2006. The data was collected by using hospital information system. A performa was developed after review of literature which included necessary information related to patient's age, sex, type of injury and species of animal involved. The information collected was analyzed in detail. Laskin and Donhoue1 classification was used to classify wounds. A total of 48 patients were reviewed. These were all males and the mean age was 25 years. Thirty three [69%] patients had soft tissue injuries, 7 [15%] had fractures, 5 [10%] had head injury and 3 [6%] had abdominal injury. Mule kick injuries occurred in 37[77%] patients, dog bite in 7[15%] cases and donkey bite in 4[8%] cases. Troops deployed in the field are exposed to the hazard of animal related injuries which can be fatal at times. The complex nature of these injuries entails early and appropriate management in order to achieve satisfactory outcome and prevent complications. Prevention strategies include proper animal handling techniques based upon animal behavior and the appropriate use of well designed confinement facilities

Febrile convulsions in children; knowledge, attitude and practices of parents

[i] To know about the knowledge, attitude and practices of parents of children with febrile convulsions. [ii] To provide adequate information of relationship between fever and febrile convulsions and its usual good prognosis. Descriptive study. It was conducted at Pediatric Department of Madina Teaching Hospital Sargodha Road Faisalabad. Two years period from January 2007-2009. 150 parents and their children with febrile convulsions were included in the study. Diagnosis was made on the basis of a history of a convulsion in the child with a febrile illness. Cases were excluded when there was doubt about the occurrence of convulsions, or if the child previously had convulsions due to any other cause, or if the physical examination or laboratory parameters suggested any other etiology for the convulsions. LP was done in case of first time febrile fits. A pretested questionnaire comprising of 12 questions was used for the study. Data was presented through frequency table. Statistical test of significance was Chi-square test. The data was analyzed with the help of SPSS computer program EQS 10 N. In the study 83 parents [59.3%] could not recognize the convulsion; 127 parents [90.7%] did not carry out any intervention prior to getting the child to the hospital. 109 [77.9%] parents did not know the facts that the convulsion can occur due to fever. For 56 [40%] of the parents every subsequent episode of fever was like a nightmare. Only 21 parents [15%] had thermometer at home and 28 [20%] knew the normal range of body temperature. Correct preventive measures were known to only 41[29.2%]. Parental fear of fever and febrile convulsion is a major problem with negative consequences affecting daily family life. The most common immediate effect of the convulsion on the parents was fear of death and insomnia and fear of brain damage

Hallervorden spatz disease

Hallervorden-Spatz disease is an extremely rare cause of dystonia that carries a poor prognosis. A case occurring in an 11-yearold girl with progressive extra-pyramidal symptoms since infancy is described. The clinical picture and typical radiological findings are described

Hypospadias: one stage repair

To evaluate the cosmetic and functional results of one stage repair of hypospadias, using parameatal based flip-flap urethroplasty. A prospective study from 1990 to 2002 at AFIU Rawalpindi, CMH Kohat, Jhelum, and Pano Aqil Cantt. And AK CMH Muzaffarabad. Fifty patients underwent one stage repair of hypospadias by parameatal based flip flap urethroplasty, using ventral penile and scrotal axial skin flap. The urethral meatus was subcoronal in 6 [12%], Distal penile in 32 [64%], proximal penile in 8 [16%] and penoscrotal in 4 [8%]. Some modifications and combinations were used to ensure better vascularity of the flaps; natural verticals slit meatus and reduce complications. An 8 Fr polythene feeding tube used as stent with its tip inside the urinary bladder was removed on 7th or 8th postoperative day. The mean follow up period was 12 to 36 months. We achieved good cosmetic and functional results in 86% patients. Urethrocutaneous fistula occurred in 3[6%] patients, meatal stenosis in 2 [4%], residual chordee in 1[2%] and disruption of repair due to flap necrosis in 1 patient. Only four patients required redo surgery for fistula, residual chordee and failed repair due to flap necrosis. Meatal stenosis responded well to regular dilatation with the cone tip of an ophthalmic ointment tube, twice daily for 2-4 weeks. Postoperatively the penis was straight with natural vertical slit meatus and good stream of urine. One stage parameatal based flip flap urethroplasty, with some modifications, give very good functional and cosmetic results in primary as well as salvage repair of hypospadias

Two-stage hypospadias repair: a method applicable to all types of hypospadias

To assess the results of two-stage repair in proximal hypospadias and cases of distal hypospadias with chordee, revision surgery and in circumcised cases. Design: Prospective study. Place and Duration of Study: Combined Military Hospital, Kharian and Pano Aqil, from July 1998 to June 2002. Patients and Nineteen patients, with distal as well as proximal hypospadias, underwent two-stage hypospadias repair during the last 04 years. Splitting of glans and full thickness grafting was carried out in the first stage. Tubularization was carried out 3-6 months later and the repair was covered with water proofing layer. The results were evaluated. Distal hypospadias was seen in 13 patients, 06 cases had proximal hypospadias, 08 patients had undergone repair previously by different techniques and 05 cases were circumcised. Chordee was seen in 12 cases. Common age of presentation was below 5 years. Adequate cosmetic and functional results were achieved in all these cases. Fistula occurred in 02 cases and meatal stenosis was seen in 01 case, which responded to regular dilatation. Two-stage hypospadias repair gives excellent cosmetic and functional results in all cases of proximal hypospadias and cases of distal hypospadias with chordee, revision surgery and circumcised cases

Polypropylene mesh repair of incisional hernia

The purpose of this study is to report the results of tension-free repair of primary and recurrent incisional hernias using polypropylene [Prolene] mesh. Design: Descriptive Study. Place and Duration of Study: Combined Military Hospital, Kharian and Pano Aqil from January 1998 to September 2002.Subjects and Twenty-seven patients underwent tension-free repair of primary and recurrent incisional hernias with polypropylene mesh in extrafascial position. Nine of them had recurrent incisional hernias, 02 hernias were irreducible and 01 presented with acute intestinal obstruction. Ten patients had hernias in the midline incision, 04 at paramedian incision and rest of them had hernias on transverse abdominal incisions. The mean age was 43.7 years. The only death occurred in a known cirrhotic presenting with obstructed hernia. Another patient was seen developing seroma and wound infection in one case. No recurrence was seen during the mean follow-up period of 2.2 years. The tension-free repair of incisional hernia, with polypropylene mesh in extrafascial position, is safe and easy procedure with acceptable morbidity and no recurrence

Hydatid disease of Bone

A case of primary hydatid disease of the right femur is reported that presented with pathological fracture and was diagnosed at the time of exploration for biopsy. The patient was treated by removal of all cysts, irrigation with scolicidal solution, bone grafting and immobilisation of the fracture followed by four cycles of oral Albendazole. Eosinophilia and serological tests reverted to normal but the patient died due to acute myocardial infarction six months later. This uncommon condition should be considered in the differential diagnosis of pathological fractures, bone pain or osteolytic lesions, especially in patients of rural and farmer background

Thyroid stimulating hormone [TSH] levels in euthyroid patients with goiter, a clinicopathological study

300 subjects, 39 males and 261 females, between the ages of 6 years and 70 years, were studied at Pakistan Institute of Medical Sciences [PIMS] and Nuclear Medicine, Oncology and Radiotherapy Institute [NORI] to assess the role of Thyroid Stimulating Hormone [TSH] in the development of goiter in euthyroid goitrous population of Islamabad and Rawalpindi area. The euthyroid goitrous subjects were selected by clinical Examination. Radioisotope uptake scan was done to confirm the clinical assessment of the status of the thyroid gland. The estimation of the serum levels of the thyroid hormones and TSH was done by Radioimmunoassay [RIA] and the estimation of serum levels of immunoglobulins A, G and M by Radial Immunodiffusion [RID]. TSH was found to be elevated in 9% of the study subjects while immunoglobulins were elevated in 66.67% of the subjects. The results of the study reveal the goitrogenic role of TSH in a small portion, while immunological phenomenon appears to be active in a significant portion of the euthyroid goitrous population of Islamabad and Rawalpindi area

Retropubic prostatectomy for benign prostatic hyperplasia: an analysis of 140 cases

To evaluate the result of retropubic prostatectomy for beingn prostatic hyperplasia. Design: A longitudual descriptive study. Place and Duration of Study: It was conducted during July, 1998 to December, 1999. Subjects and A total of 140 patients with BPH undergoing retropubic prostatectomy were studied. Patients age ranged from 51-97 years with maximum incidence in the sixties, 80 [57%] patients presented with urinary retention while 54 [38.5%] with mixed obstructive and irritative symptoms. The success or outcome was recorded by interviewing. Late complication were also recorded. No blood was transfused in 97 [69.2%] patients during or after operation. There was no case of postoperative hemorrhage.Transient urge incontinence was noted postoperatively on removal of catheter which improved within two days to three weeks. Stricture in posterior urethra was seen in only 3 [2%] cases. One [0.7%] patient expired because of myocardial infarction during hospital admission. Retropubic prostatectomy is an excellent procedure where facilities for TURP are not available

Surgical audit of solitary thyroid nodule

Between January 1997 to January 2000, 113 patients underwent thyroidectomy for solitary thyroid nodules in Department of Surgery Combined Military Hospital Kharian. Majority of patients belonged to Azad Kashmir, District Gujrat and Jehlum. Patients age ranged from 13 to 70 years, with 88 females [77.8%] and 25 males [22.1%]. Thyroid scan was carried out in 90 cases and ultrasound examination was done in 7 cases. Fine needle aspiration cytology [FNAC] was done in 94 cases preoperatively. Near total or total lobectomy and Isthmectomy was done in 84 cases and 18 cases underwent nodulectomy. Isthmectomy was done in 7 cases for nodules located in the isthmus. 4 cases underwent total thyroidectomy. Postoperatively there was slight hoarseness of voice in 4 cases and there was no case of postoperative haemorrhage or mortality. Malignancy was seen in only 5 cases [4.4%]. It was seen both in cold [4.6%] as well as in warm [4.4%] nodules. In this hospital based study the incidence of malignancy was less [4.4%] in solitary thyroid nodule compared with international figure of 4.7-18.3% and majority are undergoing operation for what is subsequently shown to be benign thyroid disease. These patients can be safely observed without operation after fine needle aspiration cytology has declared it benign. The information p[provided by thyroid scan has less bearing in the management. Fine needle aspiration cytology [FNAC] provides useful information and may be used along with other clinical information to decide best form of treatment in a solitary thyroid nodule

Relationship between liver cancer and trace metals scalp hair

The aim of this investigation was to use scalp hair as a possible indicator of trace element abnormality and to ascertain whether or not differences in their levels may occur due to liver cancer and subsequent treatment. The concentration of Cr, Cu, Fe, Mn, Ni, Pb, Sr, Zn, Ca, and Mg were determined by atomic absorption spectrophotometry. This study showed higher average concentrations of Cu, Fe, Mn, and Mg in normal, as compared with diseased male subjects. Levels of Pb, however, were lower in normal male subjects as compared to the diseased male patients. Diseased female patients showed lower concentrations of Fe, Ca and Mg, as compared to normal female subjects. Levels of Ni and Zn were higher in diseased, as compared to the normal females. The correlation coefficient study did not reveal strong positive correlation between any trace elements in diseased and normal subjects. However, the regression equation showed a significant role of Ca, Fe, Mg and Zn in scalp hair. of normal and diseased subjects. T-test analysis showed distinct Fe and Mg levels for each male and female groups. Hence, Fe and Mg may perhaps play an important role in the diseased and normal subjects