Evaluation of mucin histochemistry in relation to p63 expression in nodular hyperplasia and adenocarcinoma of prostate

Background: Prostate cancer is a leading cause of death in men. Nodular hyperplasia and adenocarcinoma are common causes of prostatic enlargement. Diagnosis of these lesions on routine biopsies can be difficult for pathologists. Immunohistochemical stain p63 can help, but it is costly and not widely available. The present study aimed to evaluate the usefulness of mucin histochemistry in relation to p63 expression in differentiating nodular hyperplasia and adenocarcinoma of prostate. Methods: This study was conducted in the department of pathology at Dhaka medical college from July 2018 to June 2020. 50 cases of prostatic lesions (25 NHP and 25 adenocarcinoma) were examined using histomorphology. The sections were stained with periodic acid Schiff (PAS) to identify neutral mucins and Alcian blue (2.5 pH) to identify acidic mucins. Additionally, p63 antibody was used in immunohistochemistry. Results: NHP showed positivity for neutral mucin (96% with PAS stain) but not for acidic mucin (Alcian blue stain), while prostatic carcinoma showed positivity for both neutral mucin (28%) and acidic mucin (44%). The grade group 1 tumors of prostatic carcinoma showed 100% positivity for acid mucin, with a decrease in Alcian blue staining as the grade increased. P63 was positive in 100% of NHP cases and negative in 100% of prostatic carcinoma cases. Conclusions: Positivity for acidic mucins with Alcian blue stain can be a helpful diagnostic tool to differentiate well differentiated adenocarcinomas from benign lesions where facility for p63 immuno-stain is not available and poor people who cannot afford the cost of immunohistochemistry.

A comparative study of obstetrics outcome of placenta previa in scarred versus unscarred uterus at tertiary Hospital, Kathmandu, Nepal

Background: Placenta previa is an obstetric life-threatening condition with several maternal and fetal complications. The objective of this study is to compare the maternal and fetal outcome of placenta previa in scarred and unscarred uterus.Methods: A retrospective case control study was carried out on 85 cases of placenta previa in the department of obstetrics and gynecology, Paropakar Maternity and Womens Hospital (PMWH) Kathmandu from April 2019 to May 2020 of which 46 had scarred uterus and 39 cases had unscarred uterus.Results: Sixty-one of patients were less than 30 years of age, 62% presented with gestational age 28 to 37 weeks and 67% had parity between 1 to 5. Frequency of placenta previa in scarred uterus was 54% and that in unscarred uterus was 46%. Eighty percent cases with scarred uterus had anterior placenta compared to 33% of cases of unscarred uterus with p value of 0.009. 42% had grade 4 placenta previa on ultrasonography. 45 percent of patient with scarred uterus had PPH compared to 23% in unscarred group with p value of 0.03. Malpresentation was found in 7 cases in scarred group and in one case in unscarred. Cesarean hysterectomy was performed in 6 cases in scarred category compared to 2 in unscarred. Low birth weight was present in 28 cases in scarred category compared to 15 cases in unscarred category with p value 0.03.Conclusions: This study concluded that fetal and maternal outcome is adverse for cases of placenta previa with scarred uterus compared to unscarred uterus.

Efficacy and safety of a fixed dose combination of paracetamol, chlorpheniramine maleate and phenylephrine in treatment of common cold: a phase IV, open-labelled, multi-centric study

Background: Acute coryza or common cold affects the upper airways, sometimes in association with low-grade fever and systemic symptoms, and usually presents with at least two of the following symptoms: cough, dysphonia, throat discomfort, sore throat, nasal congestion, rhinorrhoea, sneezing, headaches, myalgia and fever. A triple combination of analgesics, decongestants and antihistamines provides better relief for multiple symptoms in common cold and allergic rhinitis according to various studies. A combination of Paracetamol as an analgesic, anti-inflammatory and antipyretic, Chlorpheniramine maleate, an anti-histaminic and Phenylephrine as a nasal decongestant is popular in the treatment of common cold. Hence the present study was planned to evaluate efficacy and safety of this combination in treatment of common cold.Methods: This was a phase IV, open-labelled, multicentric study in 159 patients. Efficacy assessment was done by analyzing the reduction in mean TSS at each follow-up visit and safety assessment was done by analyzing the adverse events during the study.Results: There was reduction in mean TSS from 6.62 (day 1) to 3.56 (day 3) and 0.69 (day 5). Most of the patients had >50% reduction in total symptom score at visit 3 and 58.49% patients had complete relief from the symptoms at the end of study. Out of 159 patients, 26 i.e. 16.36% experienced adverse events. Sedation and drowsiness (6.29%) were the most common adverse event seen in patients.Conclusions: A fixed dose combination of Chlorpheniramine maleate, Paracetamol, and Phenylephrine is safe and effective in the treatment of common cold.

Molecular genetic diagnosis of beta thalassemia in Pakistan

A set of procedures, based on DNA analysis, has been developed to detect deletions and point mutations causing Beta thalassemia in the Pakistani population. These procedures can be used to analyze the presence of relevant changes in DNA, thus providing a reliable means for screening the high risk families, to provide them genetic counseling and prenatal diagnosis during early pregnancy. We have identified two mutations IVS-1 nt.5 [G--C] and codon 8-9 [+G] in 4 of the 6 families analysed for these mutations

Screening for inherited metabolic disorders at Shaikh Zayed hospital

Intermarriages within the families are prevalent in the Pakistani society which may cause spread of genetic disorders. To assess the magnitude of the problem a preliminary screening program was started. Out of the 116 screened, 54 [or 49.5%] were those whose relatives were affected. Family history was available in only 109 cases. Among them the parents of 64 were first, second or distant counsins

Serum cholinesterase levels in a sample village population

Serum cholinesterase [CHS] levels in a sample village population in Pakistan were estimated. It was found that three in 45 [6.7%] of the subjects had quite low CHS levels whereas six out of 45 subjects [13.3%] had moderately low cholinesterase levels. It is suspected that this low CHS level probably was due to actual exposure or exposure to spray-drift of organophosphorous pesticides used in the agricultural fields

case of alkaptonuria

A five and a half months old baby boy was brought to the Pediatrics Department, Shaikh Zayed Hospital, Lahore on November 27, 1989 with a complaint of passing, since birth, normal color urine which turns dark on standing. Clinically Alkaptonuria was diagnosed, strongly supported by biochemical tests