Facial morphology analysis of children with non-syndromic cleft lip and palate in a local population.

Objectives: To study the facial morphology in children with non-syndromic cleft lip and palate by applying numerical facial analysis on photographs for planning and evaluating treatment outcomes. Methods: This descriptive study was conducted from March 2020 to July 2020 in the Department of Oral Pathology, University of Health Sciences and Cleft Lip and Palate Hospital, Lahore Pakistan. A total of 104 patients of both genders with an age range from three months to thirteen years were included. Photographs of the participants were taken to measure facial anthropometrical landmarks including facial height, nose width, mouth width and inter canthal distance. The association between facial measurements with gender and phenotype and across age groups were computed keeping the confidence level at 95%. Results: Mean age of the children was 72.43±44.2 months with slight male predominance. Thirty-one percent presented with bilateral cleft lip and palate followed by unilateral cleft lip and plate. Total mean facial height, nose width and mouth width were found to be 143.46±21.52mm, 32.24±5.03mm and 33.71±4.38mm respectively. Intercanthal distance was measured to be 31.04±5.99mm. Statistically significant association was observed between gender and facial height, nose width, mouth width and Intercanthal distance. Conclusion: Facial anthropometric measures done on frontal photographs can be used to identify the facial landmarks in children with non-syndromic cleft lip and palate in low resource stings that may help surgeons in getting better aesthetic outcomes. These landmarks vary between ethnic groups therefore these should be specific to a particular race and ethnicity so as to ensure proper aesthetics and improved quality of life for the children of all nations.

Histopathological Changes in Arsenic Kushta Induced Nephrotoxicity in Wistar Rats.

OBJECTIVE: To determine the nephrotoxic effects of arsenic kushta (Kushta Sam-ul-Far) in Wistar rats. STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Morbid Anatomy and Histopathology, University of Health Sciences, Lahore from May to August 2014. METHODOLOGY: This experimental study was conducted on 48 healthy Wistar rats, each weighing 200 - 250 grams. The rats were randomly divided into 4 experimental groups each containing 12 rats. Group I was taken as control given flour pellets. Group II was given single dose (180 mg/kg) of arsenic kushta for 2 weeks. Group III received 150 mg/kg of arsenic kushta for 12 weeks; whereas, group IV was also given 150 mg/kg of arsenic kushta for 12 weeks along with 75 mg of BSA (bovine serum albumin). Histopathological changes in glomeruli, tubules and interstitium were noted in the kidney. RESULTS: Mesangial proliferation, thickening of basement membrane, necrosis, and interstitial edema were mainly observed in all the above groups except group I which served as control. These changes were seen in greater severity in high dose groups and the group given BSA injection along with kushta (group III, IV). CONCLUSION: Herbo-mineral preparations of arsenic kushta are nephrotoxic in rats and may have similar toxic effects in human beings.

Evaluation of Various Nuclear Cytological Changes in Normal Buccal Mucosa and Peritumoural Area in Patients with Oral Squamous Cell Carcinoma Receiving Concomitant Chemoradiotherapy.

Objectives. To evaluate the role of serial cytological assay in calculating the nuclear response of contralateral normal buccal mucosa and peritumoural area of squamous cell carcinoma of oral cavity in patients receiving fractionated radiotherapy (RT) and chemotherapy. Materials and Methods. This prospective, nonrandomized study was comprised of 76 histologically confirmed cases of oral squamous cell carcinoma on cyclical chemoradiation treatment. Chemoradiosensitivity was evaluated using serial scrape smears taken before and after immediate exposure to CCRT, at 17th day of CCRT (mid of treatment), and at the end of treatment. The nuclear changes, such as multinucleation, micronucleation, karyorrhexis, karyolysis, nuclear budding, prominent nucleoli, and binucleation occurring in both irradiated cancer cells and contralateral normal buccal mucosa, had a statistically significant dose related increase with concomitant chemoradiotherapy (p < 0.05). Conclusion. We recommend regular use of serial cytological assay during CCRT as it may prove to be a valuable tool for assessment of chemoradiosensitivity and persistence of tumour/dysplastic cells after radiotherapy.

Expression of Prostanoid EP3 Receptors in Oral Squamous Epithelium and Oral Squamous Cell Carcinoma.

Objectives. To carry out a descriptive analysis of the expression of the EP3 receptors of PGE2 in different histological grades of OSCC and adjacent normal epithelium. Material and Methods. A total of 46 patients presenting with various histological subtypes and grades of OSCC were recruited from Maxillofacial Surgery Department of Nishtar Institute of Dentistry Multan. Microscopically tumour subtyping and histological grading according to Anneroth's grading system were carried out. Immunohistochemical staining with rabbit polyclonal EP3 receptor antibody was performed and sections were scored for intensity and proportion of positive adjacent squamous epithelial and tumour cells. Results. Out of 46 patients n = 28 (60.9%) were well differentiated, n = 15 (32.6%) were moderately differentiated, and only n = 3 (6.5%) were poorly differentiated. All n = 46 cases of OSCC were positive for EP3 receptor antibody, n = 14 (30.4%) cases had strong intensity of anti EP3 antibody staining in tumour tissue, n = 17 (37%) cases showed moderate intensity, and n = 15 (32.6%) cases showed weak intensity. Conclusion. Prostanoid EP3 receptors are widely but variably expressed in OSCC. Most of well differentiated OSCC cases show a moderate to strong expression of EP3 receptors. However, insignificant statistical relation to histological grades of OSCC has been observed. This might be due to small sample size of the study.

Negative association of serum IL-6 and IL-17 with type-II diabetes retinopathy.

BACKGROUND: Diabetes mellitus (DM) is a health concern which leads to complications such as retinopathy. Pakistan has 6.9 million people living with DM and this toll will be doubled by 2025. OBJECTIVE: To determine serum IL-6 and IL-17 of type 2 diabetes mellitus (T2DM) patients with retinopathy. METHODS: In this cross-sectional case-control study, 212 subjects enrolled which were categorized into 3 groups. Group-I included 30 subjects without diabetes, group-II consisted of 30 subjects with T2DM without retinopathy and group-III consisted of 152 subjects with T2DM and retinopathy. Serum IL-6 and IL-17 levels were determined by ELISA. Data was analysed using SPSS 17.0 and one way ANOVA to observe group mean differences. RESULTS: Longer mean duration of disease was detected in group-III than group-II (p=0.007). Highest IL-6 level was detected in group-II and highest IL-17 level was detected in group-I. For IL-6, significant differences were detected among groups in total, between Group-I and Group-III and between Group-II and Group-III (p<0.0001 each). Regarding IL-17, significant differences were found among groups in total (p=0.002) and between Group-I and Group-III (p=0.001). No significant difference in the percentages of HbA1c observed between groups. CONCLUSIONS: Age, gender and duration of diabetes contribute to T2DM retinopathy. Serum IL-6 and IL-17 were inversely associated with T2DM retinopathy.

Immunohistochemical expression and correlation of mammaglobin with the grading system of breast carcinoma.

OBJECTIVES: In this study it was intended to study mammaglobin expression as a marker for the detection of breast cancer and correlate it with the Bloom-Richardson grading system of breast carcinoma. MATERIALS AND METHODS: The study was conducted from May 2007 to May 2008. Tissue samples were collected from 50 patients of breast cancer in the various stages of their disease and correlated histologically with the Bloom-Richardson grading system for breast carcinoma. The clinical data of the patients were obtained from their respective files. RESULTS: Positive immunostaining for mammaglobin was seen in 84% of breast carcinoma cases. This immunoreactivity did not correlate with histological and nuclear grades of the tumors, yet it varied according to the histological type of the tumor with ductal carcinoma showing stronger and diffuse staining than other varieties. CONCLUSION: These results elicit that mammaglobin is overexpressed in carcinoma breast as compared to the normal breast epithelium. This mammaglobin expression can act as a useful tool in the diagnosis of women with breast cancer.

Pattern of police torture in Punjab, Pakistan.

A total of 1820 victims of alleged police torture were examined at the office of Surgeon Medicolegal Punjab Lahore during a period of 5 years. Most of the victims at the time of examination were showing visible evidence of Physical trauma. Victims were mainly men. Examination was conducted on the directions of various courts (Judicial Magistrates, District and Session Judges, and Lahore High Court). A wide range of different types of injuries of different durations were observed on various parts of the body. Blunt trauma was most frequent. Psychologic element of torture was also seen in some victims.

Ki-67 proliferating index and histological grade, type and stage of colorectal carcinoma.

BACKGROUND: The objective of this study was to assess the relationship of histological type, grade and stage of colorectal carcinoma with proliferative activity as measured by Ki-67 LI. It was a descriptive study and conducted at the Department of Pathology, University of Health Sciences, Lahore. METHODS: Ki-67 is a protein associated with cell proliferation and is expressed in all the phases of cell cycle except G0. In the present study, Ki-67 expression in 50 patients with colorectal adenocarcinomas was observed using immunohistochemistry with monoclonal antibody MIB-1. RESULTS: Ki-67 LI was high in well and moderately differentiated adenocarcinomas (mean Ki-67 LI 392.50 +/- 56.58 and 342.24 +/- 96.84 respectively) as compared to poorly differentiated adenocarcinomas (mean Ki-67 LI 250.00 +/- 113.46). Ki-67 LI was high in non mucinous adenocarcinomas than mucin secreting and signet ring cell adenocarcinomas (mean Ki-67 393.93 +/- 55.91 vs 220.00 +/- 49.72 and 200.00 +/- 79.05 respectively). As regard the Dukes' staging, Ki-67 LI was high in colorectal carcinomas in Dukes' stage B than tumours in Dukes' stage C (Mean Ki-67 LI 360.13 +/- 90.03 vs 241.66 +/- 101.31 respectively). CONCLUSION: The proliferative activity as measured by Ki-67 antibody is related to histological type, grade and stage.

A comparison of histological appearances of Hodgkin's disease in Pakistani and Saudi patients.

BACKGROUND: Hodgkin's disease (HD) is a relatively rare lymphoma that affects younger as well as older persons. It is reported in the Western as well as Asian studies that HD is a rare disease in developing world. It is commoner in males in most of the countries and shows a bimodal pattern of age. The commonest subtype is nodular sclerosis in the west and mixed cellularity in the eastern and developing countries. The present study compares eight years' data of HD as regard age, sex, site of anatomical presentation and subtypes according to WHO classification among Pakistani and Saudi patients. METHODS: This retrospective comparative study included 211 cases of HD from various institutions of Lahore, Pakistan; and 78 cases retrieved from the data of King Abdul Aziz Hospital and Oncology Centre, Jeddah, Saudi Arabia. RESULTS: The analysis of both data of HD showed lack of bimodal age pattern and was common among younger age. Male was the dominating sex. Cervical group of lymph nodes was the commonest presenting site. Mixed cellularity HD (MCHD) was the commonest subtype among Pakistani patients whereas Nodular Sclerotic HD (NSHD) was more common among Saudis. CONCLUSION: A comparison of the pattern of Pakistani and Saudi data of HD showed lack of bimodality in both. The male sex predominated. Morphologically the MCHD and NSHD were the commonest subtypes in Pakistani & Saudi patients respectively.

A randomized double-blind comparative study of terbinafine for 1, 2 and 4 weeks in tinea capitis.

We report a randomized, double-blind study, comparing the relative efficacy and tolerability of oral terbinafine, given for 1, 2 or 4 weeks, in tinea capitis. Of 161 evaluable patients, 53 were treated with terbinafine for 1 week, 51 for 2 weeks and 57 for 4 weeks. Isolated pathogens included Trichophyton violaceum (71.5%), T. tonsurans (14.9%), T. verrucosum (4.3%), Microsporum audouinii (4.3%), M. canis (2.5%), T. schoenleinii (1.9%) and T. mentagrophytes (0.6%). The final evaluation, at 12 weeks, showed cure rates of 73.6, 80.4 and 85.9%, in the respective groups. The adverse effects noted, were not drug related. In our opinion, terbinafine given for 1, 2 or 4 weeks, is equally effective for most cases of tinea capitis.

Tinea capitis in Lahore, Pakistan.

BACKGROUND: The causative fungi of tinea capitis vary with geography and time. This study was planned to identify the etiologic agents and determine clinicoetiologic correlations of tinea capitis in Lahore, Pakistan. METHODS: From clinically suspected cases of tinea capitis, skin scrapings and hair samples were taken and subjected to microscopy and culture. RESULTS: Of 180 evaluable patients, 95% were children below 12 years of age with equal sex incidence. Noninflammatory lesions were seen in 62.2% of cases. Trichophyton violaceum was the most common etiologic agent responsible for 69.4% of infection, followed by T. tonsurans (16.7%), T. verrucosum (10%), Microsporum audouinii (2.2%), and T. mentagrophytes (1.7%). CONCLUSIONS: T. violaceum is the predominant pathogen causing tinea capitis in children and adults in this part of the world and gives rise to a varied clinical picture. Our findings agree with data from other parts of Pakistan and many countries abroad.

An immunofluorescence study of renal lesions in diabetes mellitus.

Percutaneous renal biopsies were performed in 30 diabetic patients who presented with proteinuria. Tissues were studied for evidence of an immune lesion using immunofluorescence techniques. No consistent pattern of binding of FITC labelled polyvalent, monospecific IgG, IgA, IgM and labelled bovine insulin antisera in various diabetic renal lesions could be demonstrated. The binding of labelled insulin was observed even in biopsies of patients who had never received exogenous insulin therapy. It was therefore concluded that there is no evidence to support an immune pathogenesis in the morphogenesis of the diabetic renal lesions, nor do these lesions occur as a result of insulin therapy.

An open clinical pilot study of the efficacy and safety of oral terbinafine in dry non-inflammatory tinea capitis.

Ten patients with dry non-inflammatory tinea capitis were evaluated in a pilot study which ran from September 1989 to February 1990. Each patient was given oral terbinafine for 6 weeks; each was followed up 2 weeks later. Eight (80%) were completely cured, one (10%) was mycologically cured and showed minimal signs and symptoms, and another (10%) showed improvement (negative mycology, but persistent clinical signs and symptoms). No topical or systemic side-effects were noted. Terbinafine appears to be an effective and safe antifungal agent in the treatment of non-inflammatory tinea capitis.

Effects of prolonged poisoning by Russell's viper venom on blood coagulation, platelets and fibrinolysis.

The effects of Russell's viper venom on blood coagulation, platelets and the fibrinolytic enzyme system were studied in rabbits after injecting repeated doses of 0.05 MLD of the venom. Thrombocytopenia was the earliest change to appear. It was followed by rise in serum fibrinogen degradation products and prolongation of prothrombin time, activated partial thromboplastin time and thrombin time indicating a progressive consumption coagulopathy and activation of fibrinolysis. Red blood cell morphology was unchanged during the first three weeks; whereas the fragmentation appeared after the fourth week and it increased in severity with further envenomations, i.e. when chronic DIC was established.

Gold nephropathy in rabbits using an indigenous preparation. A morphological study.

Experimental nephropathy has been induced in rabbits using an indigenous preparation of gold, popularly known as "Gold Kushta ". Proteinuria and associated renal glomerular lesions of variable severity were observed in the animals on Kushta feed and those injected with sodium aurothiomalate. In addition, a probable mechanism of gold-induced nephropathy is also discussed.