Pub Date : 2023-07-06DOI: 10.35787/jimdc.v12i2.948
S. Haider, Muhammad Waqas Raza, Aurangzeb Khan, Munaima Khan, Khurram Waqas, Malik Irfan Ahmed
Introduction: Loop Ileostomy is a surgical procedure which is done to divert intestinal contents away from distal bowel to allow healing of the distal anastomosis and also for the relieve of obstruction in emergency situations. Reversal is done through local stoma site via linear closure technique as the standard procedure. Surgical site infection is the most commonly occurring & morbid complications of this technique and it can be reduced if closure is done by Purse string method. The aim of this study was to determine the more effective method of the two in terms of post-op surgical site infection. Material & Methods: This Randomized Controlled Trial was conducted for six-month duration in Benazir Bhutto Hospital, Rawalpindi. Reversal patients presenting in outdoor-department were included and allocated randomly into either Purse-String closure group or linear skin closure group. Follow-up was done for thirty days and wound infection was identified by presence of purulent discharge from incision site. Organisms were isolated from fluid culture or tissue culture from the wound or abscess. Results: We included a total of 90 patients in this study. 45 patients were randomly alloted to each group. The two groups were matched for various entry parameters. Wound infection was observed among 27(60%) in the linear closure group whereas 12(26.7%) in the purse-string group developed wound infection. This difference was statistically significant. Conclusion: Given the low rate of associated wound infection, purse string closure of stoma reversal is recommended to be the preferred procedure for ileostomy reversal. Key words: Loop Ileostomy, Linear closure, Purse string closure, Wound infection
{"title":"Comparison of Wound Infection after Reversal of Loop Ileostomy in Linear versus Purse-String Skin Closure of Stoma Site","authors":"S. Haider, Muhammad Waqas Raza, Aurangzeb Khan, Munaima Khan, Khurram Waqas, Malik Irfan Ahmed","doi":"10.35787/jimdc.v12i2.948","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.948","url":null,"abstract":"Introduction: Loop Ileostomy is a surgical procedure which is done to divert intestinal contents away from distal bowel to allow healing of the distal anastomosis and also for the relieve of obstruction in emergency situations. Reversal is done through local stoma site via linear closure technique as the standard procedure. Surgical site infection is the most commonly occurring & morbid complications of this technique and it can be reduced if closure is done by Purse string method. The aim of this study was to determine the more effective method of the two in terms of post-op surgical site infection. \u0000Material & Methods: This Randomized Controlled Trial was conducted for six-month duration in Benazir Bhutto Hospital, Rawalpindi. Reversal patients presenting in outdoor-department were included and allocated randomly into either Purse-String closure group or linear skin closure group. Follow-up was done for thirty days and wound infection was identified by presence of purulent discharge from incision site. Organisms were isolated from fluid culture or tissue culture from the wound or abscess. \u0000Results: We included a total of 90 patients in this study. 45 patients were randomly alloted to each group. The two groups were matched for various entry parameters. Wound infection was observed among 27(60%) in the linear closure group whereas 12(26.7%) in the purse-string group developed wound infection. This difference was statistically significant. \u0000Conclusion: Given the low rate of associated wound infection, purse string closure of stoma reversal is recommended to be the preferred procedure for ileostomy reversal. \u0000Key words: Loop Ileostomy, Linear closure, Purse string closure, Wound infection","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84881465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-06DOI: 10.35787/jimdc.v12i2.934
Murtaza Ahmed Khan
Background: Prevalence of obesity is increasing worldwide and obese patients constitute a major portion of the spinal surgeon s practice. The patients with lumbar disc herniation present the most in the outpatient department of neurosurgery. Obesity not only leads to the disc herniation but also causes a surgeon a difficult ordeal while operating as it leads to more peri operative complications than normal weight patients. This cross-sectional study was planned to see the impact of obesity on lumbar disc herniation and its association with disease outcome. Methodology This study was conducted in the department of neurosurgery at Sir Ganga Ram Hospital/ Fatima Jinnah Medical University (N=604; Males: n=368 Females: n=236) from December 15th 2021 to July 31st 2022. From the prospective registry, patients undergoing unilateral fenestration and discectomy, bilateral partial laminectomy and discectomy, and endoscopic discectomy were identified with complete BMI data. Results: In total 604 patients, 368 were males and 236 were females, with age range 25-55 years with ± 4.9 SD. Among these 187 (30.9%) were managed surgically while 417 (69.1%) patients were managed conservatively, which were assessed on VAS (Visual Analogue Score) and Sciatica Bothersomeness Index (SBI). Among them 87 patients (20.8%) patients were of normal weight, 145 (34.77%) were overweight and 185 (44.36%) were obese. Among187 patients who underwent surgery; 74 (39.5%) underwent unilateral fenestration and discectomy, 113 (60.4%) underwent bilateral partial laminectomy and discectomy whereas 16 patients (8.5%) underwent endoscopic discectomy. Lumber Disc Herniation (LDH) was more frequent in obese and overweight individuals than in normal-weight patients. Conclusion It was observed that in obese and overweight patients, the severity of pain was more as compared to normal patients. Higher the BMI more the excruciating pain and more neurological were seen with increasing trend of numbness and radiculopathy. Hence, obesity may have a robust impact on lumbar disc herniation apart from other pathologies involved. Key words: Discectomy, Disc herniation, Laminectomy, Lumbar region, Obesity.
背景:肥胖的患病率在世界范围内不断增加，肥胖患者构成了脊柱外科手术的主要部分。腰椎间盘突出症患者以神经外科门诊最多。肥胖不仅会导致椎间盘突出，而且与正常体重的患者相比，肥胖患者的围手术期并发症更多，手术过程也会非常艰难。本横断面研究旨在观察肥胖对腰椎间盘突出症的影响及其与疾病预后的关系。本研究在Sir Ganga Ram医院/法蒂玛真纳医科大学神经外科进行(N=604;从2021年12月15日到2022年7月31日，男性:n=368女性:n=236。从前瞻性登记中，接受单侧开窗和椎间盘切除术、双侧部分椎板切除术和椎间盘切除术以及内窥镜椎间盘切除术的患者被确定为具有完整的BMI数据。结果:共604例患者，其中男性368例，女性236例，年龄25 ~ 55岁，SD±4.9。其中手术治疗187例(30.9%)，保守治疗417例(69.1%)，采用视觉模拟评分(VAS)和坐骨神经痛困扰指数(SBI)进行评估。其中体重正常87例(20.8%)，超重145例(34.77%)，肥胖185例(44.36%)。187例接受手术的患者中;74例(39.5%)行单侧开窗椎间盘切除术，113例(60.4%)行双侧部分椎板切除术和椎间盘切除术，16例(8.5%)行内窥镜椎间盘切除术。腰椎间盘突出症(LDH)在肥胖和超重个体中比在正常体重患者中更常见。结论肥胖和超重患者的疼痛程度明显高于正常患者。体重指数越高，剧烈疼痛和神经性疼痛越严重，麻木和神经根病呈增加趋势。因此，除了涉及的其他病理外，肥胖可能对腰椎间盘突出症有强烈的影响。关键词:椎间盘切除术，椎间盘突出，椎板切除术，腰椎区，肥胖。
{"title":"Impact of Obesity on Lumbar Disc Herniation","authors":"Murtaza Ahmed Khan","doi":"10.35787/jimdc.v12i2.934","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.934","url":null,"abstract":"Background: Prevalence of obesity is increasing worldwide and obese patients constitute a major portion of the spinal surgeon s practice. The patients with lumbar disc herniation present the most in the outpatient department of neurosurgery. Obesity not only leads to the disc herniation but also causes a surgeon a difficult ordeal while operating as it leads to more peri operative complications than normal weight patients. This cross-sectional study was planned to see the impact of obesity on lumbar disc herniation and its association with disease outcome. \u0000Methodology This study was conducted in the department of neurosurgery at Sir Ganga Ram Hospital/ Fatima Jinnah Medical University (N=604; Males: n=368 Females: n=236) from December 15th 2021 to July 31st 2022. From the prospective registry, patients undergoing unilateral fenestration and discectomy, bilateral partial laminectomy and discectomy, and endoscopic discectomy were identified with complete BMI data. \u0000Results: In total 604 patients, 368 were males and 236 were females, with age range 25-55 years with ± 4.9 SD. Among these 187 (30.9%) were managed surgically while 417 (69.1%) patients were managed conservatively, which were assessed on VAS (Visual Analogue Score) and Sciatica Bothersomeness Index (SBI). Among them 87 patients (20.8%) patients were of normal weight, 145 (34.77%) were overweight and 185 (44.36%) were obese. Among187 patients who underwent surgery; 74 (39.5%) underwent unilateral fenestration and discectomy, 113 (60.4%) underwent bilateral partial laminectomy and discectomy whereas 16 patients (8.5%) underwent endoscopic discectomy. Lumber Disc Herniation (LDH) was more frequent in obese and overweight individuals than in normal-weight patients. \u0000Conclusion It was observed that in obese and overweight patients, the severity of pain was more as compared to normal patients. Higher the BMI more the excruciating pain and more neurological were seen with increasing trend of numbness and radiculopathy. Hence, obesity may have a robust impact on lumbar disc herniation apart from other pathologies involved. \u0000Key words: Discectomy, Disc herniation, Laminectomy, Lumbar region, Obesity.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87170111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-06DOI: 10.35787/jimdc.v12i2.817
R. Usman, Duaa Ajaz Hussain, Muhammad Jamil Malik, M. Anwar, M. Anwer, A. Shahab
Background: Arteriovenous malformations result in abnormal communication between veins and arteries. Treatment of AVMs can be surgical or non-surgical. This study aimed to assess the response of Peripheral Arteriovenous Malformations (AVMs) to various treatment modalities. Methodology: This cross-sectional study was performed at Combined Military Hospital Lahore, Rawalpindi, and Midcity Hospital, Lahore Pakistan, from January 2016 to June 2020. Patients were divided into two groups based on gender. Their demographic data, clinical presentation, and treatments provided were assessed and comparison was done using Chi-Square Test. Results: Of the 43 patients, 74.4% (n=32) were females with a male-to-female ratio of 1:3. Mean age was 27± 6 years (males) and 17± 4 years (females). Low-flow AVMs were more prevalent in females (81%, n=27). In males, 50% (n=5) AVMs were on the trunk whereas in females 93.9% (n=31) AVMs were on limbs. Doppler-guided foam sclerotherapy (DGFS) as the sole treatment was used in 95.3% (n=41) patients while 32.5% (n=14) patients underwent DGFS followed by surgical excision. In 4.6% (n=2) cases, angioembolization followed by surgical excision was done. One patient was treated with sirolimus. Recurrence was found in 20.9% (n=9) cases, of which 66.6% (n=6) had high-flow AVMs. Conclusion: Male patients presented late and with mostly high-flow head and neck AVMs. Sclerotherapy alone or surgical excision with preoperative sclerotherapy or embolotherapy is an efficacious curative treatment for AVMs while sirolimus can be offered as a palliative option. Key words: Arteriovenous Malformations, Enbucrilate, Sclerotherapy, Vascular Malformations
{"title":"Peripheral Arteriovenous Malformations and their Response to Treatment Modalities: Experience at Tertiary Care Hospitals","authors":"R. Usman, Duaa Ajaz Hussain, Muhammad Jamil Malik, M. Anwar, M. Anwer, A. Shahab","doi":"10.35787/jimdc.v12i2.817","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.817","url":null,"abstract":"Background: Arteriovenous malformations result in abnormal communication between veins and arteries. Treatment of AVMs can be surgical or non-surgical. This study aimed to assess the response of Peripheral Arteriovenous Malformations (AVMs) to various treatment modalities. \u0000Methodology: This cross-sectional study was performed at Combined Military Hospital Lahore, Rawalpindi, and Midcity Hospital, Lahore Pakistan, from January 2016 to June 2020. Patients were divided into two groups based on gender. Their demographic data, clinical presentation, and treatments provided were assessed and comparison was done using Chi-Square Test. \u0000Results: Of the 43 patients, 74.4% (n=32) were females with a male-to-female ratio of 1:3. Mean age was 27± 6 years (males) and 17± 4 years (females). Low-flow AVMs were more prevalent in females (81%, n=27). In males, 50% (n=5) AVMs were on the trunk whereas in females 93.9% (n=31) AVMs were on limbs. Doppler-guided foam sclerotherapy (DGFS) as the sole treatment was used in 95.3% (n=41) patients while 32.5% (n=14) patients underwent DGFS followed by surgical excision. In 4.6% (n=2) cases, angioembolization followed by surgical excision was done. One patient was treated with sirolimus. Recurrence was found in 20.9% (n=9) cases, of which 66.6% (n=6) had high-flow AVMs. \u0000Conclusion: Male patients presented late and with mostly high-flow head and neck AVMs. Sclerotherapy alone or surgical excision with preoperative sclerotherapy or embolotherapy is an efficacious curative treatment for AVMs while sirolimus can be offered as a palliative option. \u0000Key words: Arteriovenous Malformations, Enbucrilate, Sclerotherapy, Vascular Malformations","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84462829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-06DOI: 10.35787/jimdc.v12i2.782
K. Sultan
Background: This study was conducted to determine pattern (spectrum) of renal diseases on basis of renal biopsy in a tertiary care hospital in Islamabad. Methodology: This retrospective observational study was conducted at Nephrology department of Pakistan Institute of Medical Sciences Islamabad from February 2012 to April 2020. Results of all biopsies done during this period were analyzed to determine the prevalence of different renal diseases on basis of histopathology and immunofluorescence. Results: There were 254 kidney biopsy samples studied during the course of study. Out of total 254 patients 133 (52.4%) were male and 121 (47.6%) were female. Mean age of participants was 34.47±7.67 years (Range:15-60 years). Primary glomerulonephritis and secondary glomerulonephritis was found in 169 (66.5%) and 48 (18.9%) respectively, while tubulo-interstitial disease was reported in 37 (14.6%) of the total biopsies. Among 169 biopsies that showed primary GN, IgA Nephropathy (IgAN) was the most common in 16% of the biopsies, followed by membranous GN in 15.4% while membranoproliferative GN (MPGN) was seen in 13.6%, and focal and segmental glomerulosclerosis (FSGS) was seen in 13% of primary GN. Among 48 biopsies with secondary GN, lupus nephritis (LN) was found to be most common in 83.3% followed by amyloidosis in 6.3%. Among 37 biopsies having tubulo-interstitial disease, acute tubular nephritis (ATN) and renal cortical necrosis was seen in 29.7% each followed by tubulo-interstitial nephritis in 18.9% and acute interstitial nephritis (AIN) was seen in 16.2%. Conclusion: This study shows that primary GN is the most common finding on renal biopsy. Among them IgA Nephropathy is the commonest lesion followed by membranous nephropathy, MPGN and FSGS. Among secondary GN, Lupus Nephritis is the commonest lesion. Key words: Glomerulonephritis, Renal Biopsy, Renal Disease, Renal histopathology
{"title":"Pattern of Biopsy-Proven Renal Dysfunction in Pakistan: A Single Center Experience","authors":"K. Sultan","doi":"10.35787/jimdc.v12i2.782","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.782","url":null,"abstract":"Background: This study was conducted to determine pattern (spectrum) of renal diseases on basis of renal biopsy in a tertiary care hospital in Islamabad. \u0000Methodology: This retrospective observational study was conducted at Nephrology department of Pakistan Institute of Medical Sciences Islamabad from February 2012 to April 2020. Results of all biopsies done during this period were analyzed to determine the prevalence of different renal diseases on basis of histopathology and immunofluorescence. \u0000Results: There were 254 kidney biopsy samples studied during the course of study. Out of total 254 patients 133 (52.4%) were male and 121 (47.6%) were female. Mean age of participants was 34.47±7.67 years (Range:15-60 years). Primary glomerulonephritis and secondary glomerulonephritis was found in 169 (66.5%) and 48 (18.9%) respectively, while tubulo-interstitial disease was reported in 37 (14.6%) of the total biopsies. Among 169 biopsies that showed primary GN, IgA Nephropathy (IgAN) was the most common in 16% of the biopsies, followed by membranous GN in 15.4% while membranoproliferative GN (MPGN) was seen in 13.6%, and focal and segmental glomerulosclerosis (FSGS) was seen in 13% of primary GN. Among 48 biopsies with secondary GN, lupus nephritis (LN) was found to be most common in 83.3% followed by amyloidosis in 6.3%. Among 37 biopsies having tubulo-interstitial disease, acute tubular nephritis (ATN) and renal cortical necrosis was seen in 29.7% each followed by tubulo-interstitial nephritis in 18.9% and acute interstitial nephritis (AIN) was seen in 16.2%. \u0000Conclusion: This study shows that primary GN is the most common finding on renal biopsy. Among them IgA Nephropathy is the commonest lesion followed by membranous nephropathy, MPGN and FSGS. Among secondary GN, Lupus Nephritis is the commonest lesion. \u0000Key words: Glomerulonephritis, Renal Biopsy, Renal Disease, Renal histopathology","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78377433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-06DOI: 10.35787/jimdc.v12i2.927
Hafsa Arshad Azam Raja, Dr. Arsalan Manzoor Mughal, Prof. Syed Tehzeeb Ul Hassan, Beenish Sabir, Sheikh Mohammad Ahmad
Background: This study was conducted to study the variations in the number and location of nutrient and epiphyseal vascular foramina of the femur in the Pakistani population Methodology: This descriptive cross-sectional study was conducted from April -June '2022 after getting ethical approval. Data collection tool: 24-gauge hypodermic needles & measuring tapes. Data collection and Analysis: SPSS & Excel Inclusion & exclusion criteria: Anatomically sound bones were included from the bone bank of RMU; pathological, deformed bones were excluded Results: Out of 80 bones 66.6% had single nutrient foramina, whereas 31.3% had two on the shaft. 82.05% of foramina were type II, 16.67% were type I and 1.26% were type III. Only 2.5% had no foramina. Majorly the nutrient foramina were found on the medial surface, medial lips or between the lips of linea aspera. There was no significant difference bilaterally in the mean foraminal index, foraminal length, or several epiphyseal vascular foramina, which were 18.65 cm, 42.66 cm, and 16 cm respectively. Conclusion: Most of the nutrient foramina in the femora were found in the middle third of the shaft, either on the medial lip of the Linea Aspera or on the shaft’s medial surface; however, variations in their location have been found. The mean epiphyseal vascular foramen ranged from 6 to 26. The article finds its implications in orthopaedic surgery and osteogenesis. Key words: Epiphyses, Diaphysis, Femur, long bones, Hip joint, Arteries, Pathology, Research, osteogenesis, Population
{"title":"A A Descriptive Correlational Study of Vascular Foramina in Adult Human Femora in Cadavers in Pakistan","authors":"Hafsa Arshad Azam Raja, Dr. Arsalan Manzoor Mughal, Prof. Syed Tehzeeb Ul Hassan, Beenish Sabir, Sheikh Mohammad Ahmad","doi":"10.35787/jimdc.v12i2.927","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.927","url":null,"abstract":"Background: This study was conducted to study the variations in the number and location of nutrient and epiphyseal vascular foramina of the femur in the Pakistani population \u0000Methodology: This descriptive cross-sectional study was conducted from April -June '2022 after getting ethical approval. Data collection tool: 24-gauge hypodermic needles & measuring tapes. \u0000Data collection and Analysis: SPSS & Excel \u0000Inclusion & exclusion criteria: Anatomically sound bones were included from the bone bank of RMU; pathological, deformed bones were excluded \u0000Results: Out of 80 bones 66.6% had single nutrient foramina, whereas 31.3% had two on the shaft. 82.05% of foramina were type II, 16.67% were type I and 1.26% were type III. Only 2.5% had no foramina. Majorly the nutrient foramina were found on the medial surface, medial lips or between the lips of linea aspera. There was no significant difference bilaterally in the mean foraminal index, foraminal length, or several epiphyseal vascular foramina, which were 18.65 cm, 42.66 cm, and 16 cm respectively. \u0000Conclusion: Most of the nutrient foramina in the femora were found in the middle third of the shaft, either on the medial lip of the Linea Aspera or on the shaft’s medial surface; however, variations in their location have been found. The mean epiphyseal vascular foramen ranged from 6 to 26. \u0000The article finds its implications in orthopaedic surgery and osteogenesis. \u0000Key words: Epiphyses, Diaphysis, Femur, long bones, Hip joint, Arteries, Pathology, Research, osteogenesis, Population","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85681425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-06DOI: 10.35787/jimdc.v12i2.845
N. Nabi, Qudsia Ishaq, Armaghana Qamar Khan, Summaya Sohail chaudhry, Anam Ishaq, Ashok Kumar Tanwani
Introduction: In previous studies, role of stromal component in epithelial malignancies has been highlighted. CD10 is a member of metalloproteinase family that breaks down the protein components of extracellular matrix and epithelial tissue remodeling thus playing an important role in carcinogenesis and metastasis. To evaluate CD 10 expression in breast carcinoma and assess its association with grade of the tumor, ER, PR and Her 2 Neu status. Methodology: The study was carried in Federal Government Polyclinic Hospital (FGPH) and Pakistan Institute of Medical Sciences (PIMS), Islamabadԁ. Immunohistochemical panel of CD 10, ER, PR and Her 2 was applied to 171 cases of invasive breast carcinoma. The association of CD 10 anԁ ER/PR status was evaluated. Results: Among 171 cases of breast carcinoma, 77.8% cases were CD-10 positive. A total of 65.5% of ER negative cases expressed strongly positive CD-10 in the stroma as compared to 37.2% of ER positive cases (P=0.001). In 64.4% of PR negative cases expressed strong positivity of CD-10 in the stroma compareԁ with 37.5% (42/112) PR positive cases (P=0.001). The association of CD-10 with HER-2-NEU was not significant (P=0.749). Association of high-grade tumor with CD 10 was not statistically significant (P=0.258). Conclusion: It was observed that CD10 expression is associated with negative ER, PR status and with higher grades of the tumors, showing its prognostic significance. Key Words: Breast cancer, CD 10, Estrogen receptors, HER2neu, Progesterone receptors
{"title":"The Stromal Expression of CD-10 in Breast Carcinoma and its Association with Estrogen, Progesterone receptors, Her2Neu and Tumor Grade","authors":"N. Nabi, Qudsia Ishaq, Armaghana Qamar Khan, Summaya Sohail chaudhry, Anam Ishaq, Ashok Kumar Tanwani","doi":"10.35787/jimdc.v12i2.845","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.845","url":null,"abstract":"Introduction: In previous studies, role of stromal component in epithelial malignancies has been highlighted. CD10 is a member of metalloproteinase family that breaks down the protein components of extracellular matrix and epithelial tissue remodeling thus playing an important role in carcinogenesis and metastasis. \u0000To evaluate CD 10 expression in breast carcinoma and assess its association with grade of the tumor, ER, PR and Her 2 Neu status. \u0000Methodology: The study was carried in Federal Government Polyclinic Hospital (FGPH) and Pakistan Institute of Medical Sciences (PIMS), Islamabadԁ. Immunohistochemical panel of CD 10, ER, PR and Her 2 was applied to 171 cases of invasive breast carcinoma. The association of CD 10 anԁ ER/PR status was evaluated. \u0000Results: Among 171 cases of breast carcinoma, 77.8% cases were CD-10 positive. A total of 65.5% of ER negative cases expressed strongly positive CD-10 in the stroma as compared to 37.2% of ER positive cases (P=0.001). In 64.4% of PR negative cases expressed strong positivity of CD-10 in the stroma compareԁ with 37.5% (42/112) PR positive cases (P=0.001). The association of CD-10 with HER-2-NEU was not significant (P=0.749). Association of high-grade tumor with CD 10 was not statistically significant (P=0.258). \u0000Conclusion: It was observed that CD10 expression is associated with negative ER, PR status and with higher grades of the tumors, showing its prognostic significance. \u0000Key Words: Breast cancer, CD 10, Estrogen receptors, HER2neu, Progesterone receptors \u0000 ","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90521015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-06DOI: 10.35787/jimdc.v12i2.1010
Admin Jimdc, Usman Waheed, Nasim Hosseini
{"title":"Voluntary Blood Donation and Social Media","authors":"Admin Jimdc, Usman Waheed, Nasim Hosseini","doi":"10.35787/jimdc.v12i2.1010","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.1010","url":null,"abstract":"","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89411608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-06DOI: 10.35787/jimdc.v12i2.981
I. Ullah, A. Arshad, U. Waheed, Noore Saba, Z. Qasim, M. Arshad
Introduction: Single-nucleotide polymorphism (SNP) in human platelet antigens (HPAs) glycoproteins leads to alloimmunizations and platelet disorders such as posttransfusion purpura, neonatal alloimmune thrombocytopenia, and refractoriness to platelet transfusion. To study the prevalence in a particular ethnic group, genomic DNA is used to genotype HPAs. Detection of these polymorphisms is imperative to identify the risk of alloimmunization and the provision of HPAs. Current study was planned to determine the frequency of HPAs in the Pakistani population of blood donors. Methodology: Genomic DNA was extracted from blood samples of 300 randomly selected platelet donors from five major cities of Pakistan (Islamabad, Peshawar, Karachi, Quetta, and Mirpur). This study was approved by the ethical committee of Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. Prior informed consent was taken from all the participants. Sequence-specific primers for platelets glycoprotein genes were designed using Primer 3 online software. The distinct targets were amplified through PCR. Amplified PCR products were eluted from the gel after electrophoresed, purified and sequenced. All the sequences and data obtained were analyzed through SPSS version 25. Results: Genotyping of samples showed that among the subjected HPA systems, HPA-1, HPA-5, HPA-7w, HPA-19w, and HPA-21w systems were found to have both a and b alleles in the Pakistani population while only aa genotype was found in HPA-4, HPA-6w, HPA-8w, HPA-10w, HPA-11w, HPA-16w, and HPA-23w. The frequency of HPA-1a was 0.9333 and HPA-1b was 0.0666, HPA-5a was 0.8033 and HPA-5b was 0.1966, HPA-7wa was 0.98 and HPA-7wb was 0.02, HPA-19wa was 0.95 and HPA-19wb was 0.05 and HPA-21wa was 0.9866 and HPA-21wb was 0.0133. Among the analyzed HPAs, the mismatch probability was higher in HPA-5 while it was lower in HPA-21w. Conclusion: HPA-4b, HPA-6b, HPA- 8b, HPA-10b, HPA-11b, HPA-16b and HPA-23b were absent. No homozygosity was found in the remaining genotyped HPAs. Our study suggests that it is necessary to establish HPA screening sites in blood banks to have HPA typed donor registry providing compatible therapeutic platelets to all unimmunized patients. Our data will be useful to understand and better treat the alloimmune-mediated platelet disorders. Key words: Alloantigens, Genotyping, Sequencing, Platelets, Platelet alloantigens
人类血小板抗原(HPAs)糖蛋白的单核苷酸多态性(SNP)导致异体免疫和血小板疾病，如输血后紫癜、新生儿异体免疫性血小板减少症和血小板输注难耐。为了研究特定族群的患病率，基因组DNA被用于hpa基因型。检测这些多态性对于确定同种异体免疫的风险和提供hpa是必要的。目前的研究计划确定巴基斯坦献血者中hpa的频率。方法:从巴基斯坦5个主要城市(伊斯兰堡、白沙瓦、卡拉奇、奎达和米尔普尔)随机抽取300名血小板献血者的血样中提取基因组DNA。本研究得到了巴基斯坦伊斯兰堡Shaheed Zulfiqar Ali Bhutto医科大学伦理委员会的批准。所有参与者事先获得知情同意。利用Primer 3在线软件设计血小板糖蛋白基因序列特异性引物。通过PCR扩增出不同的靶点。扩增的PCR产物经电泳、纯化和测序后从凝胶中洗脱。所有得到的序列和数据均通过SPSS version 25进行分析。结果:样本基因分型显示，在巴基斯坦人群中，HPA-1、HPA-5、HPA-7w、HPA-19w和HPA-21w系统中均存在a和b等位基因，而在HPA-4、HPA-6w、HPA-8w、HPA-10w、HPA-11w、HPA-16w和HPA-23w中仅存在aa基因型。HPA-1a频率为0.9333,HPA-1b频率为0.0666,HPA-5a频率为0.8033,HPA-5b频率为0.1966,HPA-7wa频率为0.98,HPA-7wb频率为0.02,HPA-19wa频率为0.95,HPA-19wb频率为0.05,HPA-21wa频率为0.9866,HPA-21wb频率为0.0133。在所分析的hpa中，HPA-5的错配概率较高，而HPA-21w的错配概率较低。结论:HPA-4b、HPA-6b、HPA- 8b、HPA-10b、HPA-11b、HPA-16b、HPA-23b缺失。其余基因型hpa未发现纯合性。我们的研究表明，有必要在血库中建立HPA筛查点，以建立HPA型供体登记，为所有未免疫的患者提供兼容的治疗性血小板。我们的数据将有助于理解和更好地治疗同种异体免疫介导的血小板疾病。关键词:同种抗原，基因分型，测序，血小板，血小板同种抗原
{"title":"Genotyping of Platelet Alloantigens by DNA Sequencing in Pakistani Population","authors":"I. Ullah, A. Arshad, U. Waheed, Noore Saba, Z. Qasim, M. Arshad","doi":"10.35787/jimdc.v12i2.981","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.981","url":null,"abstract":"Introduction: Single-nucleotide polymorphism (SNP) in human platelet antigens (HPAs) glycoproteins leads to alloimmunizations and platelet disorders such as posttransfusion purpura, neonatal alloimmune thrombocytopenia, and refractoriness to platelet transfusion. To study the prevalence in a particular ethnic group, genomic DNA is used to genotype HPAs. Detection of these polymorphisms is imperative to identify the risk of alloimmunization and the provision of HPAs. Current study was planned to determine the frequency of HPAs in the Pakistani population of blood donors. \u0000Methodology: Genomic DNA was extracted from blood samples of 300 randomly selected platelet donors from five major cities of Pakistan (Islamabad, Peshawar, Karachi, Quetta, and Mirpur). This study was approved by the ethical committee of Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. Prior informed consent was taken from all the participants. Sequence-specific primers for platelets glycoprotein genes were designed using Primer 3 online software. The distinct targets were amplified through PCR. Amplified PCR products were eluted from the gel after electrophoresed, purified and sequenced. All the sequences and data obtained were analyzed through SPSS version 25. \u0000Results: Genotyping of samples showed that among the subjected HPA systems, HPA-1, HPA-5, HPA-7w, HPA-19w, and HPA-21w systems were found to have both a and b alleles in the Pakistani population while only aa genotype was found in HPA-4, HPA-6w, HPA-8w, HPA-10w, HPA-11w, HPA-16w, and HPA-23w. The frequency of HPA-1a was 0.9333 and HPA-1b was 0.0666, HPA-5a was 0.8033 and HPA-5b was 0.1966, HPA-7wa was 0.98 and HPA-7wb was 0.02, HPA-19wa was 0.95 and HPA-19wb was 0.05 and HPA-21wa was 0.9866 and HPA-21wb was 0.0133. Among the analyzed HPAs, the mismatch probability was higher in HPA-5 while it was lower in HPA-21w. \u0000Conclusion: HPA-4b, HPA-6b, HPA- 8b, HPA-10b, HPA-11b, HPA-16b and HPA-23b were absent. No homozygosity was found in the remaining genotyped HPAs. Our study suggests that it is necessary to establish HPA screening sites in blood banks to have HPA typed donor registry providing compatible therapeutic platelets to all unimmunized patients. Our data will be useful to understand and better treat the alloimmune-mediated platelet disorders. \u0000Key words: Alloantigens, Genotyping, Sequencing, Platelets, Platelet alloantigens","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72445085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Diabetes Mellitus is a chronic disease and with rapidly increasing prevalence, it requires continuous diabetic care beyond just glycemic control. It needs continuous self-management and multi factorial risk reduction strategies. This study aims to assess the self-care practices of diabetic patients living in Rawalpindi and to determine the relationship of sociodemographic characteristics with their self-care practices. Methodology: This cross-sectional study was conducted in two private diabetic clinics of Rawalpindi from February to July 2022. A validated structured questionnaire using Summary of Diabetes Self-Care Activities (SDSCA) scale was administered to assess self-care practices of the study participants. A total of 230 participants through convenience sampling aged 25 to 86 years were recruited in the survey. SPSS version 22 was used to carry out the statistical analysis. Results: The current study comprised of 107(46.5%) males and 123 (53.5%) females with mean age of 54.85 ±12.41 years. Among them, 65.2% had adequate self-care practices. It was found that marital status (p=0.004), educational status (p=0.002), monthly income (p=0.001) and duration of diabetes (p=0.006) were significantly associated with self-care practices of the participants. Conclusion: More than half of the participants had adequate self-care practices. Sociodemographic variables like marital status, education, monthly household income and duration of diabetes were significantly associated with the self-care practices of diabetic patients. Key words: Diabetes Mellitus, Pakistan, Self-Care, Self- Management, Survey
背景:糖尿病是一种慢性疾病，发病率迅速上升，需要持续的糖尿病护理，而不仅仅是控制血糖。它需要持续的自我管理和多因素风险降低战略。本研究旨在评估生活在拉瓦尔品第的糖尿病患者的自我保健行为，并确定社会人口学特征与其自我保健行为的关系。方法:横断面研究于2022年2月至7月在拉瓦尔品第的两家私人糖尿病诊所进行。采用糖尿病自我护理活动摘要(SDSCA)量表对研究参与者的自我护理行为进行评估。通过方便抽样，共招募了230名年龄在25岁至86岁之间的参与者。采用SPSS version 22进行统计分析。结果:男性107例(46.5%)，女性123例(53.5%)，平均年龄54.85±12.41岁。其中65.2%的人有足够的自我护理习惯。婚姻状况(p=0.004)、受教育程度(p=0.002)、月收入(p=0.001)和糖尿病病程(p=0.006)与自我保健行为显著相关。结论:超过一半的参与者有足够的自我保健实践。婚姻状况、受教育程度、家庭月收入、糖尿病病程等社会人口学变量与糖尿病患者的自我保健行为显著相关。关键词:糖尿病;巴基斯坦;自我护理
{"title":"The Assessment of Self Care Practices amongst Diabetic Patients of Rawalpindi, Pakistan","authors":"Rubab Zulfiqar, Sumaira Masood, H. Masood, Uzma Hassan, Bibi Razia Bano, Rimsha Tahreem","doi":"10.35787/jimdc.v12i2.929","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.929","url":null,"abstract":"Background: Diabetes Mellitus is a chronic disease and with rapidly increasing prevalence, it requires continuous diabetic care beyond just glycemic control. It needs continuous self-management and multi factorial risk reduction strategies. This study aims to assess the self-care practices of diabetic patients living in Rawalpindi and to determine the relationship of sociodemographic characteristics with their self-care practices. \u0000Methodology: This cross-sectional study was conducted in two private diabetic clinics of Rawalpindi from February to July 2022. A validated structured questionnaire using Summary of Diabetes Self-Care Activities (SDSCA) scale was administered to assess self-care practices of the study participants. A total of 230 participants through convenience sampling aged 25 to 86 years were recruited in the survey. SPSS version 22 was used to carry out the statistical analysis. \u0000Results: The current study comprised of 107(46.5%) males and 123 (53.5%) females with mean age of 54.85 ±12.41 years. Among them, 65.2% had adequate self-care practices. It was found that marital status (p=0.004), educational status (p=0.002), monthly income (p=0.001) and duration of diabetes (p=0.006) were significantly associated with self-care practices of the participants. \u0000Conclusion: More than half of the participants had adequate self-care practices. Sociodemographic variables like marital status, education, monthly household income and duration of diabetes were significantly associated with the self-care practices of diabetic patients. \u0000Key words: Diabetes Mellitus, Pakistan, Self-Care, Self- Management, Survey","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74326736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-19DOI: 10.35787/jimdc.v12i1.855
Sana Arbab, Munawar Aziz Khattak, Imran Khattak, Yusra Jamil, Faiza Ijaz, Ambereen Hamayun
Background: The Cusp of Carabelli is a small additional cusp which is situated on the mesiopalatal surface of first maxillary molars. This nonfunctional cusp comes in many forms including furrows, ridges or pits and is collectively known as the Carabelli trait Objective: To evaluate the frequency of the occlusal contacts between the accessory cusp of Carabelli and the opposing arch tooth among both genders in patients attending the out-patients department of Peshawar Dental Hospital, Peshawar Methodology: This descriptive cross-sectional study was conducted on 300 subjects visiting the OPD of Peshawar Dental Hospital from October 2022 to December 2022. The sample size was calculated using WHO formula N=p(100-p)z2/d2 (Http://www.fao.orgThe age group selected for the participants was from 13-30 years. Consecutive sampling technique was used.). Articulating paper was used to assess the occlusal contacts caused by the cusp of Carabelli. The data were analyzed using SPSS version 20. Pearson’s chi square test was applied to analyze the data. P value of ≤ 0.05 was considered statistically significant. Results: The results of the current study showed that 10.7% of the participants experienced occlusal contacts caused by the presence of their accessory cusp with the opposing arch tooth with no statistically significant difference between genders. Conclusion: The cusp of Carabelli is the most prevailing variation found on the palatal aspect of mesiopalatal cusp of permanent maxillary first molars in a hospital-based inhabitants of Peshawar with rare occlusal contacts experienced by the patients. Key words: Cusp of Carabelli, Maxillary permanent first molars, Occlusal contact.
背景:Carabelli尖是位于第一上颌磨牙中腭面上的一个小的附加尖。这种无功能的牙尖有多种形式，包括沟状、脊状或凹状，统称为Carabelli特征目的:评估在白沙瓦牙科医院门诊部就诊的男女患者中，Carabelli副牙尖与对侧弓牙之间咬合接触的频率。本研究对2022年10月至2022年12月在白沙瓦牙科医院门诊就诊的300名受试者进行了描述性横断面研究。样本量计算采用WHO公式N=p(100-p)z2/d2 (Http://www.fao.orgThe)，年龄为13-30岁。采用连续抽样技术)。用咬合试纸评价Carabelli牙尖引起的咬合接触。数据采用SPSS version 20进行分析。采用Pearson卡方检验对数据进行分析。P值≤0.05认为有统计学意义。结果:本研究结果显示，10.7%的参与者因其副尖牙与对侧弓牙的存在而发生咬合接触，性别差异无统计学意义。结论:Carabelli尖是白沙瓦某医院常住上颌第一磨牙中腭尖腭面最常见的变异，患者的咬合接触很少。关键词:Carabelli尖，上颌第一恒磨牙，咬合接触。
{"title":"Evaluation of the Occlusal Contact between the Opposing Teeth and the Cusp of Carabelli in Maxillary Permanent First Molars in Patients Visiting Peshawar Dental College","authors":"Sana Arbab, Munawar Aziz Khattak, Imran Khattak, Yusra Jamil, Faiza Ijaz, Ambereen Hamayun","doi":"10.35787/jimdc.v12i1.855","DOIUrl":"https://doi.org/10.35787/jimdc.v12i1.855","url":null,"abstract":"Background: The Cusp of Carabelli is a small additional cusp which is situated on the mesiopalatal surface of first maxillary molars. This nonfunctional cusp comes in many forms including furrows, ridges or pits and is collectively known as the Carabelli trait \u0000Objective: To evaluate the frequency of the occlusal contacts between the accessory cusp of Carabelli and the opposing arch tooth among both genders in patients attending the out-patients department of Peshawar Dental Hospital, Peshawar \u0000Methodology: This descriptive cross-sectional study was conducted on 300 subjects visiting the OPD of Peshawar Dental Hospital from October 2022 to December 2022. The sample size was calculated using WHO formula N=p(100-p)z2/d2 (Http://www.fao.orgThe age group selected for the participants was from 13-30 years. Consecutive sampling technique was used.). Articulating paper was used to assess the occlusal contacts caused by the cusp of Carabelli. The data were analyzed using SPSS version 20. Pearson’s chi square test was applied to analyze the data. P value of ≤ 0.05 was considered statistically significant. \u0000Results: The results of the current study showed that 10.7% of the participants experienced occlusal contacts caused by the presence of their accessory cusp with the opposing arch tooth with no statistically significant difference between genders. \u0000Conclusion: The cusp of Carabelli is the most prevailing variation found on the palatal aspect of mesiopalatal cusp of permanent maxillary first molars in a hospital-based inhabitants of Peshawar with rare occlusal contacts experienced by the patients. \u0000Key words: Cusp of Carabelli, Maxillary permanent first molars, Occlusal contact.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72953727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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