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1.
Journal of Sheikh Zayed Medical College [JSZMC]. 2017; 8 (4): 1295-1297
em Inglês | IMEMR | ID: emr-190505

RESUMO

Background: Prostate cancer incidence is rising leading to a major health problem globally. Infectious complications in TRUS guided prostate biopsy are very common without antibiotic prophylaxis


Objective: To compare the effect of single dose and three day ciprofloxacin prophylaxis regimen for prevention of urinary tract infection after prostatic biopsy


Methodology: This randomized controlled trial involved 130 patients with Prostate cancer which were randomly allocated into 2 groups. Group-A received two ciprofloxacin 500 mg tablets stat while Group-B received 3 days has of ciprofloxacin treatment. Patients were followed up to 5 days to observe any symptoms of UTI. Written informed consent was taken from all the patients. The data was entered and analyzed using SPSS version 19


Results: The mean age of the patients was 56.84 +/- 7.28 years. The mean age of the patients in Group-A was 56.44 +/- 7.10 years while in Group-B it was 57.23 +/- 7.50 years. However, there was no statistically significant difference between groups in terms of age. On follow up at 5 days, 11 patients has UTI. The rate of presence of UTI was similar across different age groups and treatment regimens. Treatment with one-day antibiotic prophylaxis resulted in UTI in 6[9,2%] associated with in comparison to three days' antibiotic treatment, where 5 [7.6%] has UTI. [P=0.64]


Conclusion: The incidence of UTI with one-day antibiotic prophylaxis with ciprofloxacin was comparable to three antibiotic treatments in patients who are candidates for TRUS guided biopsy

2.
Journal of Sheikh Zayed Medical College [JSZMC]. 2017; 8 (2): 1163-1166
em Inglês | IMEMR | ID: emr-191086

RESUMO

Background: Hypospadias is a congenital abnormality characterized by opening of external urethral meatus on ventral aspect of the penis with an overall incidence of 1:300. Different treatment modalities have been employed in the treatment of distal penile hypospadias with varying degrees of success and complications. A number of studies have compared Mathieu and Snodgrass Techniques but the existing evidence is doubtful owing to small sample size and great variation in their results


Objective: To compare the outcome of Mathieu repair with that of tubularized incised Plate Urethroplasty [Snodgrass] in distal penile hypospadias


Methodology: 90 patients meeting the inclusion and exclusion criteria's were selected and divided into two equal groups randomly using lottery method. Group-A was treated by Mathieu technique and Group-B underwent Snodgrass repair. Operative time was noted in minutes from the start of procedure till the end. Patients were followed post-operatively at 15[th] day, 1 Month and 2 Months and functional recovery and complications were evaluated


Results: The age of the patient ranged from 1 to 25 years in both groups with mean age of 6.67+/-5.74 years in Group-A and 6.65+/-6.06 years in Group-B [p=0.982]. Snodgrass was better in terms of mean operative time [67.37+/-8.85 minutes versus 87.86+/-8.22; p=0.00] as compared to Mathieu technique. The functional outcome in terms of meatal location at tip was better in Snodgrass [93.7% versus 80.2%; p=0.003] with a lower fistula rate [5.4% versus 21.6%; p=0.00] as compared to Mathieu technique


Conclusion: Tubularized Incised Plate Urethroplasty [Snodgrass] is better than Mathieu technique for the treatment of distal penile hypospadias in terms of operative time, success and complication rate

3.
PAFMJ-Pakistan Armed Forces Medical Journal. 2016; 66 (1): 30-34
em Inglês | IMEMR | ID: emr-178733

RESUMO

Objective: To determine the difference between diagnosis and misdiagnosis after medical autopsy


Study Design: Prospective study


Place and Duration of Study: Histopathology Dept Army Medical College Rawalpindi and Military Hospital [MH] Rawalpindi from Jan 2009 to May 2012


Material and Methods: A retrospective cross sectional descriptive study of medical autopsies was conducted on patients at Histopathology Department Army Medical College and MH Rawalpindi who expired at or was brought in dead at MH Rawalpindi during a 41 months period between January 2009 to May 2012. Permission from the ethical committee was obtained for the study. Autopsy for medical purpose was performed on the deceased after receiving written consent from the next of kin. Medical autopsies were performed to determine and find the medical cause of death and to evaluate any disease or injury that may be present. Total of 72 medical autopsies were conducted during the above period. All these consecutive autopsies were included in the study. Ratio of total autopsies done was 0.17% of total hospital deaths at MH Rawalpindi in the duration of study. All subjects were male, military persons, aged between 19 and 50 years. Mean age was 35.5 years. Data was analyzed in excel. Descriptive statistics was applied on qualita ive variables. Frequency and parentages was used


Results: Ante mortem diagnosis confirmed as correct on total of 25/72 Autopsies. Clinically missed / wrong diagnosis was found on 47/72 autopsies


Conclusion: Medical autopsy even today in the environment of a tertiary care hospital has irrefutable contribution in establishing final diagnosis and determining errors and omissions. Consequently it has pivotal role in continued improvement in medical care and in study of evolving disease patterns in real time

4.
Medical Forum Monthly. 2016; 27 (9): 9-13
em Inglês | IMEMR | ID: emr-184039

RESUMO

Objective: To compare the maternal and perinatal outcomes of prolonged pregnancy between active and conservative group


Study Design: Quasi experimental study


Place and Duration of Study: This study was conducted at the Department of Obstetrics / Gynaecology Unit-1, Mother and Child Health Centre, Pakistan Institute of Medical Sciences, Islamabad from March 2003 to Feb. 2004


Materials and Methods: There were one hundred cases, fifty in each group with a technique of convenient sampling. Women with uncomplicated pregnancies at >/=41 weeks and

Results: Comparison of both groups management showed that mean duration of labour in active group was prolonged than that of conservative group [p =0.001]. Interventional deliveries rate was high in active group than conservative group with p value significant statistically. Comparison of intra-partum fetal distress, neonatal morbidity including 1 minute, 5 minute Apgar score and admissions to NICU in both groups was not statistically significant. There was no perinatal mortality in both groups


Conclusion: Active management of prolonged pregnancy increases the maternal morbidity without improving perinatal outcome

5.
PAFMJ-Pakistan Armed Forces Medical Journal. 2015; 65 (2): 189-193
em Inglês | IMEMR | ID: emr-168245

RESUMO

To evaluate the histopathological parameters of the placenta like weight, infarct and syncytial knots, at different maternal hemoglobin levels, in both qualitative and quantitative manner. Descriptive study. Army Medical College, National University of Sciences and Technology in collaboration with Department of Obstehics and Gynecology, Military Hospital, Rawalpindi, Pakistan, from December 2011 to November 2012. A total of 75 placentas were included, that were collected from full term mothers at the time of childbirth. Placental weight was taken without umbilical cord and gross placental infarcts were noted. Samples of placental tissue were taken and stained by haematoxylin and eosin [H and E]. Microscopic study was done to evaluate placental infarcts and syncytial knots. Mean placental weight at normal and low maternal hemoglobin was 581.67 +/- 83.97 g and 482.58 +/- 104.74 g respectively. Gross placental infarcts were found in all cases having low maternal hemoglobin concentration [60% cases]. Syncytial knots were found in all placentas but they were considerably more at decreasing levels of maternal hemoglobin [19.79 +/- 5.22]. The present study showed decrease in placental weight, increase in placental infarcts and syncytial knot hyperplasia at low maternal hemoglobin concentration, displaying adaptive alterations


Assuntos
Humanos , Feminino , Hemoglobinas , Infarto
6.
PAFMJ-Pakistan Armed Forces Medical Journal. 2015; 65 (1): 36-41
em Inglês | IMEMR | ID: emr-168279

RESUMO

To determine the relationship between H. pylori density with severity of chronic inflammatory infiltrate. A cross-sectional study. The study was carried out in the Department of Pathology [Histopathology], Army Medical College, National University of Sciences and Technology [NUST] Islamabad, from Nov 2011 to Nov 2012. Gastric antral biopsies of H. pylori associated chronic gastritis were included in the study. Demographic characteristics and relevant clinical information were collected. First hundred biopsies of H. pylori associated chronic gastritis were assessed for density of H. pylori and chronic inflammatory infiltrate. Histopathological features like lymphoid aggregates, ulcer slough, superficial epithelial damage, dysplasia and nuclear reactive changes were simply assessed in case of their presence or absence. A sigruficant moderate positive correlation was found between grades of H. pylori and chronic inflammatory infiltrate [rs= 0.636]. Insigruficant correlation was found with lymphoid aggregates, superficial epithelial damage, dysplasia and nuclear reactive changes. In conclusion this study corroborated the determination of histopathological parameters and depicted that, the greater the density of H. pylori mfection, the greater the degrees of chronic inflammatory infiltrate


Assuntos
Humanos , Masculino , Feminino , Gastrite/patologia , Doença Crônica , Inflamação , Estudos Transversais
7.
PAFMJ-Pakistan Armed Forces Medical Journal. 2015; 65 (1): 99-104
em Inglês | IMEMR | ID: emr-168292

RESUMO

To find out the pattern of acid base abnormalities in critically ill patients in a tertiary care health Sacility. A descriptive study. The study was carried out in the department of pathology, Combined Military Hospital Kharian from January 2013 to June 2013. Two hundred and fifty patients suffering from various diseases and presenting with exacerbation of their clinical conditions were studied. These patients were hospitalized and managed in acute care units of the hospital. Arterial blood gases were analysed to detect acid base status and their correlation with their clinical condition. Concomitant analysis of electrolytes was carried out. Tests related to concurrent illnesses e.g. renal and liver function tests, cardiac enzymes and plasma glucose were assayed by routine end point and kinetic methods. Standard reference materials were used to ensure internal quantify control of analyses. Two hundred and fifteen patients out of 250 studied suffered from acid base disorders. Gender distribution showed a higher percentage of male patients and the mean age was 70.5 +/- 17.4 years. Double acid base disorders were the commonest disorders [34%] followed by metabolic acidosis [30%]. Anion gap was calculated to further stratify metabolic acidosis and cases of diabetic ketoacidosis were the commonest in this category [47%]. Other simpie acid base disorders were relatively less frequent. Delta bicarbonate was calculated to unmask the superimposition of respiratory alkalosis or acidosis with metabolic acidosis and metabolic alkalosis. Though triple acid base disorders were noted in a small percentage of cases [05%], but n7ere found to be the most complicated and challenging. Mixed acid base disorders were associated with high mortality. A large number of critically ill patients manifested acid base abnormalities over the full spectrum of these disorders. Mixed acid base disorders were commonest and were bad prognostic indicators, most often associated with high mortality. This warrants a high index of suspicion, a thorough clinical assessment of patient and a structured approach to analyze the relevant laboratory data in the given clinical setting. Only with prompt detection of an acid base disorder, clinician can formulate an appropriate management strategy for the patient


Assuntos
Humanos , Masculino , Feminino , Estado Terminal , Centros de Atenção Terciária , Equilíbrio Ácido-Base
8.
PAFMJ-Pakistan Armed Forces Medical Journal. 2014; 64 (2): 234-236
em Inglês | IMEMR | ID: emr-154700

RESUMO

To determine the frequency of thrombocytopenia in Plasmodium vivax [P.vivax] malaria cases at two hospitals. Cross-sectional descriptive study. The study was conducted at the departments of Pathology, Combined Military Hospitals Malir and Sibi, Pakistan from Jul 2011 to Mar 2012. A total of 2709 samples were collected from febrile patients for detection of malaria parasite [944 from CMH Malir and 1765 from CMH Sibi]. Cases having infection with P. falciparum alone or having mixed infection with P. vivax and P. falciparum were excluded from the study. Both thick and thin film microscopy and immunochromatographic method [OptiMAL-IT] were used for detection of malarial parasite. Platelet counts were done using automated haematology analyser [Sysmex KX 21] with re-evaluation of low counts with manual methods. Total of 170 patients were found positive for P. vivax malaria [44 from CMH Malir and 126 from CMH Sibi]. Platelet counts ranged from 21 - 457 x loyi with a mean of 134 x loyi. Ninety five [2.1%] from CMH Malir and 4.2% from CMH Sibi out of 170 patients had thrombocytopenia, and the difference in thrombocytopenia at the two hospitals was insignificant [0.017]. Thrombocytopenia in patients with P. vivax infection is equally prevalent in the two hospitals, representing a widely different geographical area and should prompt a more thorough search for malarial parasite

9.
Pakistan Oral and Dental Journal. 2012; 32 (3): 460-463
em Inglês | IMEMR | ID: emr-155356

RESUMO

Antibiotic prescriptions have been on the increase worldwide, leading to increased antibiotic resistance. Inappropriate use of antibiotics has been blamed on lack of education and continuing professional development, and also on patient demand even when they are not required. This study was carried out to find out the pattern of prescriptions by Swedish dentists using data provided by pharmaceutical industry. The data shows that although the number of prescriptions is on the increase in Sweden, dentists still prefer to use conventional antibiotics such as Penicillin Vfor the treatment of oral diseases

10.
Pakistan Journal of Pathology. 2010; 21 (4): 120-125
em Inglês | IMEMR | ID: emr-124675

RESUMO

To evaluate the diagnostic accuracy of Pipelle biopsy as compared to endometrium of hysterectomy specimen [gold standard] in various gynaecological abnormalities pertaining to endometrium. This validation study was carried out in the Department of Histopathology, Army Medical College in collaboration with Department of Gynaecology, Military Hospital Rawalpindi from Feb 2008 to Jan 2009. Consenting 100 patients undergoing hysterectomy for various indications at Military Hospital Rawalpindi during the study period fitting the inclusion criteria were incorporated. The preoperative Pipelle and subsequent hysterectomy samples were both delivered to the laboratory in 10% formal saline. Pipelle samples were embedded as such. From the hysterectomy specimen, three representative sections were taken from endomyometrium. Both the samples were processed in automated tissue processor. Paraffin blocks of Pipelle and gold standard were made in paraffin embedding machine. Through rotary microtome, 3-5 micrometer thickness sections were made. Sections were stained by haematoxylin and eosin in autostainer and then mounted. The slides were then examined by resident histopathologist and final diagnosis was given by consultant histopathologist. Endometrial hyperplasia without atypia was a frequent pathology detected on Pipelle accounting for 16% of all cases. Diagnostic accuracy of Pipelle sampling in chronic endometritis, endometrial hyperplasia


Assuntos
Humanos , Feminino , Biópsia , Histerectomia , Hemorragia Uterina , Endometrite , Hiperplasia Endometrial , Neoplasias do Endométrio
11.
PAFMJ-Pakistan Armed Forces Medical Journal. 2010; 60 (1): 13-16
em Inglês | IMEMR | ID: emr-99160

RESUMO

To measure the levels of pregnancy associated plasma protein- A [PAPPA-A] in normal rats exposed to cigarette smoke. Experimental interventional study. Army Medical College, Rawalpindi, in collaboration with national institute of health [NIH], Islamabad. Total duration was of 4 weeks. Sixty albino rats of Sprague- Dawley strain weighing 200-250 gm, divided into two groups. Both the groups were kept in identical chambers. One group of 30 rats was further exposed to passive cigarette smoke for 4 weeks. No increase was observed in the levels of serum PAPP-A of both the groups: Passive smokers and not exposed to passive smoking i.e. P > 0.05. Smoking does not increase the levels of PAPP-A


Assuntos
Animais de Laboratório , Proteína Plasmática A Associada à Gravidez , Ratos Sprague-Dawley , Ensaio de Imunoadsorção Enzimática
12.
PAFMJ-Pakistan Armed Forces Medical Journal. 2010; 60 (1): 21-25
em Inglês | IMEMR | ID: emr-99162

RESUMO

To study the plaque vulnerability in coronary arteries taken from autopsy specimens, of individuals dying of ischemic heart disease in our setup and to compare it with atheroma of those who died of non-cardiac causes. Case control study. Study was carried out in the department of Pathology [Histopathology], Army Medical College, Rawalpindi and National University of Sciences and Technology [NUST], from June 2008 to June 2009. Sixty coronary arteries having atherosclerosis, from autopsies of patients who died of sudden cardiac death were divided into case and control groups. Case group included thirty coronary arteries having atherosclerosis from autopsies of patients of whose death was attributable to Ischemic Heart Disease [IHD]. Control group included thirty coronary arteries where atherosclerotic changes were found by chance [death not attributable to ischemic heart disease]. Plaques were assessed for fibrous cap thickness, foam cells; mean percentage of inflammatory cells on Haemotoxylin and Eosin [H and E] stained slides whereas immunohistochemical [IHC] markers for T-Cells were done by IHC stain method. In present study, foam cells are significantly more in study group than in control group [P=0.007]. Fibrous cap thickness fulfilling the criteria of vulnerable plaque was more in study group as compared to control group [P<0.001]. The present study demonstrated that there was insignificant difference [P=0.152], in the mean percentage of inflammatory cells in case group and control group. An overall significant association was found between vulnerable plaque and death due to ischemic heart disease [P<0.001]. Patients dying of ischemic heart disease have more vulnerable plaque in their coronary arteries as compared to those dying from non ischemic cause. Although this is an autopsy study but the significance of in this study can be very important to guide cardiologists to identify patients at high risk of acute coronary syndrome and use new diagnostic modalities like intravascular ultrasonography and therapeutic strategies like genomic and proteomic techniques. This will help the early detection and treatment of such cases and may ultimately reduce the incidence of sudden cardiac death


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Aterosclerose , Doença da Artéria Coronariana , Estudos de Casos e Controles , Incidência , Diagnóstico Precoce , Autopsia
13.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2009; 19 (3): 165-168
em Inglês | IMEMR | ID: emr-91624

RESUMO

To determine the effect of high dose thiamine on dyslipidemia in diabetic rats. Experimental interventional study. The Animal House/Laboratory of the National Reference Laboratory for Poultry Diseases [NRLPD]/Biochemistry Department, Army Medical College, Rawalpindi, from December 2006 to January 2007. The study was conducted on 120, 12 weeks old male albino rats of Sprague Dawley Strains randomly divided into 4 groups of 30 rats each. Group I comprised of 30 normal rats, on normal [regular] diet. Group II comprised of 30 diabetic rats, on normal [regular] diet. Group III comprised of 30 normal rats, on thiamine supplemented diet. Group IV comprised of 30 diabetic rats, on thiamine supplemented diet. Out of the 120 rats, 60 were made diabetic by injecting Alloxan. Blood glucose levels were measured by applying glucose oxidase method. Determination of total HbA1c, triglyceride, HDL [High Density Lipoproteins] and total cholesterol was performed by diagnostic kits. The significance of difference in mean values of study groups [glycemia and lipid profile] was assessed by applying ANOVA and independent Student's t-test. Significant difference was found in the levels of triglycerides, cholesterol and LDL in the diabetic rats on supplemented diet p < 0.05, but no significant difference was noticed in the value of glycosylated Hb [HbA1c] [p > 0.05] of all the 4 groups. Thiamine corrected dyslipidemia but not hyperglycemia in diabetic rats


Assuntos
Masculino , Animais de Laboratório , Dislipidemias/tratamento farmacológico , Diabetes Mellitus , HDL-Colesterol , LDL-Colesterol , Hemoglobinas Glicadas , Hiperglicemia , Ratos Sprague-Dawley
14.
Medical Forum Monthly. 2009; 20 (11): 49-53
em Inglês | IMEMR | ID: emr-111234

RESUMO

To compare and determine the safety and efficacy of transurethral electrovaporization of prostate [TUVP] over transurethral resection of prostate [TUR.P] for management of benign prostatic hyperplasia [BPH]. This comparative randomized clinical study was carried out in Pakistan Institute of Medical Sciences [PIMS] Islamabad, Pakistan from May 1997 to April 1998. One hundred patients with signs and symptoms of benign prostatic hyperplasia were selected from Urology out patient department of Pakistan Institute of Medical Sciences [PIMS] Islamabad, Pakistan. They were divided into two groups of fifty each; one group underwent TURP and other TUVP. Post operative follow ups to assess the results of both the procedures were carried out at 2, 12 and 24 weeks. For approximately the same size of prostate, the mean operation time [39.7 mins] was longer for TURP as compared to TUVP [25.22 mins]. The hemorrhage was more with TURP. Clot retention incidences were five in TURP as compared to none in TUVP. The mean volume of irrigation fluid used during operation [7.5 liters] was far less in TUVP as compared with what was required in TURP [12.0 liters]. The changes in sodium and hematocrit were monitored by taking pre and post operative blood samples. The variations in the levels before and after TUVP were negligible, while TURP group patients were noted to have post operative hyponatremia. The maximum post operative stay was 3 days in TUVP [mean 2 days] compared to 7 days in TURP [mean 6 days]. As far as post operative complications were concerned, infection and perforation incidences were more in TURF compared to TUVP. Although TURP is much effective gold standard for treating BPH, it is a bit costly with higher morbidity and complication rate as compared to TUVP which is a minimal invasive technique suitable for smaller sized prostate in high surgical risk patients


Assuntos
Humanos , Masculino , Hiperplasia Prostática/cirurgia , Prostatectomia/métodos , Ressecção Transuretral da Próstata/efeitos adversos , Complicações Pós-Operatórias , Resultado do Tratamento
15.
Medical Forum Monthly. 2009; 20 (12): 18-23
em Inglês | IMEMR | ID: emr-111257

RESUMO

To measure the White blood counts [TLC and DLC] and see their association with the glycaemic status [fasting blood glucose, glycosylated Hb] of normal and diabetic rats. This experimental study was carried out at Animal house / National Reference Laboratory for Poultry Diseases [NRLPD], Animal Division of National Agriculture Research Centre [NARC] Islamabad, Department of Biochemistry and Molecular Biology Army Medical College Rawalpindi from December 2006 to January 2007. A total of 60 albino rats [30 normal and 30 diabetic] were included in the study. Leucocytic counts were done by the visual method. Care was observed not to count clumped red cell debris. Blood glucose levels were determined by applying glucose oxidase method and the determination of total HbAlc was done using its Diagnostic kit. Significant difference was observed in the values of fasting glucose [p<0.05] but no significant difference was present in the values of Glycosylated Hb [HbAlc] [p>0.05] after experimentation. Comparison of total leukocytic count in normal and diabetic groups [p>0.05] revealed no significant difference. There was also no significant difference found in the values of Neutrophils and Lymphocytes counts [p>0.05]. Because of inadequate values of monocytes, Eosinophils and Basophils in both groups; the statistical analysis revealed no significant results. In a rat model of diabetes mellitus, hyperglycaemia of short duration has no role in producing inflammation as is indicated by no rise in the levels of otal leukocytic counts [TLC and DLC]


Assuntos
Animais de Laboratório , Modelos Animais , Glicemia , Hemoglobinas Glicadas , Ratos Sprague-Dawley , Diabetes Mellitus/veterinária , Inflamação
16.
Pakistan Journal of Pathology. 2009; 20 (3): 94-98
em Inglês | IMEMR | ID: emr-125572

RESUMO

To measure the level of C-reactive protein and find its association with the glycaemic status [fasting plasma glucose, glycosylated haemoglobin] of metabolically normal and diabetic albino rats. Total 60 Albino rats were included into [metabolically normal rats n=30; diabetic rats n =30]. Plasma glucose levels were determined by using glucose oxidase method while determination of total Hb and glycosylated hemoglobin [HbA[1]c] was done by diagnostic kit that uses weak cation-exchange resin to bind Hb. The% HbA[1]c was determined by measuring the absorbance at 415 nm of the glycosylated hemoglobin fraction and the total hemoglobin fraction. The ratio of the two absorbances gave the% of HbA[1]c. C-reactive protein was measured by the ELISA kit. Significant difference was found in the values of fasting glucose, of the normal and diabetic groups [p<0.05] but no significant difference was present in the values of HbA[1]c of both groups. There was no significant difference in the values of C-reactive protein of the normal and diabetic groups. Short duration hyperglycemia has no role in producing inflammation and raising the levels of bioinflammatory marker C-reactive protein


Assuntos
Animais de Laboratório , Biomarcadores , Glicemia , Aloxano , Diabetes Mellitus Experimental , Hemoglobinas Glicadas , Ratos , Mediadores da Inflamação
17.
PAFMJ-Pakistan Armed Forces Medical Journal. 2008; 58 (3): 292-298
em Inglês | IMEMR | ID: emr-94443

RESUMO

To evaluate the inter and intraobserver variability in the histological grading and staging according to modified Knodell scoring system. A cross-sectional comparative study. Histopathology department Army Medical College, Rawalpindi, Pakistan from June 2006 to December 2006, at the Slides and original reports of already reported chronic hepatitis C cases were retrieved from the case files. A total of 52 liver biopsies of patients were reevaluated by two pathologists. The inter and intraobserver reproducibility for grade of necroinflammation and stage of fibrosis were calculated by using kappa statistics. For grades of necroinflammation a substantial level of interobserver [kappa=0.802] and intra-observer [kappa= 0.749] reproducibility was found. Disagreement in the interobserver results was detected in 11.5% cases, with difference of only one grade in all the cases. Disagreement in the intraobserver diagnosis was noted in 15.4% cases, again with the difference of only one grade of necroinflammation. Similarly for the stage of fibrosis, a substantial level of interobserver [kappa= 0.66] and intra-observer [kappa=0.77] reproducibility was present. Main disagreement for interobserver results was of stage 2 and 3 fibrosis. For intraobserver stage of fibrosis, disagreement was found in 9 cases [17.3%]. There was disagreement in 6 of the 9 cases with fibrosis stage 3, where original histological stage was reported 4. There were 3 [5.8%] cases where presence of steatosis was missed [all in non-tabulated form of reports]. Substantial level of inter and intra-observer agreement can be achieved, both for the necroinflammatory grade and stage of fibrosis, if the scoring system of chronic hepatitis is strictly followed


Assuntos
Humanos , Masculino , Feminino , Hepatite C Crônica/diagnóstico , Biópsia , Fibrose/classificação , Estudos Transversais , Fígado/patologia , Cirrose Hepática
18.
PAFMJ-Pakistan Armed Forces Medical Journal. 2005; 56 (4): 342-346
em Inglês | IMEMR | ID: emr-128157

RESUMO

The public health importance of intestinal parasitic infestations can not be denied because of their high prevalence and global distribution. It is an established fact that intestinal parasitic infestations can lead to a number of adverse affects like anaemia, stunted physical and mental growth, abdominal colic, cholestasis, cholecystitis and pancreatitis. To assess the frequency and pattern of intestinal parasitic infestation in upper Neelum Valley [Azad Kashmir]. The study was conducted at Military Field Hospital Neelum Valley Azad Kashmir from July 2004 to Jun 2006. The patients presenting with various abdominal complaints were included in the study. The stool samples of a total of 638 patients were examined by Direct Microscopy as well as by Formal Ether Concentration Method wherever necessary. One hundred and fifteen 155 [18.02%] non duplicate stool samples were positive for intestinal parasites. There was no statistically significant difference in incidence with regard to age or gender [P > 0.05]. Ascaris lumbricoides was the most common parasite 58 [50.43%] cases followed by Tinea saginata 31 [26.96%] cases and Giardia lamblia 11 [9.57%] cases. Hymenolepis nana 6 [5.22%] cases, Trichuris trichura 5 [4.35%] cases, Entrobius vermicularis 3 [2.60%] and Entamoeba histolytica 1 [0.87%] cases were less frequent. No case of Hookworm was seen. The percentage of intestinal parasites [18.03%] is quite high in upper Neelum Valley. The helminthes are more common than protozoa. Ascaris lumbricoides is the most common parasite followed by Tinea saginata and others. Appropriate steps be taken at District level for provision of safe drinking water schemes and improvement in local sanitary conditions. The Health and Education departments should help by inculcating awareness among the general public about importance of safe drinking water, environmental and personnel hygiene alongwith periodic de-worming programmes. These measures would help in reducing the occurrence of intestinal parasites and associated adverse affects

19.
Pakistan Journal of Pathology. 2004; 15 (4): 147-152
em Inglês | IMEMR | ID: emr-68027

RESUMO

A retrospective cross sectional study was carried out at Pathology Department of Army Medical College Rawalpindi from January 1995 to December 2003 to see the morphological pattern of benign and malignant ovarian tumours. A total of 762 ovarian tumours were studied during a period of nine years. Of these, 498 [65.35%] were benign, 33 [4.33%] of borderline malignancy and 231 [30.31%] were malignant. The relative frequency of malignant ovarian tumours of all gynaecologic malignancies was found to be 24.01%. The age range of ovarian tumours was 9 to 80 years. Maximum number [66.88%] of benign tumours were in younger patients [<40 years], whereas majority of malignant tumours [65.83%] were seen in 5th to 6th decades. Histologically, the major categories included surface epithelial tumours 527 [69.16%], germ cell tumours 201 [26.37%], sex cord- stromal tumours 34 [4.46%] and miscellaneous 4 [0.52%]. Amongst the malignant tumours, the most common entity was serous cystadenocarcinoma [46.75%], followed by mucinous cystadenocarcinoma [22.94%], dysgerminoma [6.06%], granulosa cell tumours [5.62%] and endometrioid carcinoma [4.76%]. In this study, ovarian tumours were seen in younger age and serous tumours were relatively more common than experienced in the western world. Overall trends for other malignancies are more or less similar to other Pakistani studies except for mucinous carcinoma


Assuntos
Humanos , Feminino , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/diagnóstico , Estadiamento de Neoplasias , Fatores Etários , Estudos Transversais , Estudos Retrospectivos , Prognóstico
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