Title: Normocytic Norm Chromic Anemia Is Most Common Type Anemia HIV Infected Patients
Author: Dr. Sachin Sharma
Aims & Objectives -Establish care guidelines for HIV infected persion and altered haematopoiesis resulting in anaemia.Review the pathogenesis of the haematological manifestations of human immunodeficiency virus (HIV).Identify the haematological manifestations (Peripheral smear) of altered haematopoiesis resulting from HIV infection.
Material & Methods- Blood was collected in a sterile EDTA containing tube and processed following our established laboratory protocol and by universal precaution as per the guideline of National aids control organization (NACO, India). A complete blood counting including HB%,PCV, Red cell indices ,platelet count and total white cell count and differential was done by Automated blood cell counter analyzer of all the patient on antiretroviral therapy .The all cell count indices including WBC count with differential and platelet count, was further confirmed by manual oil immersion smear study method.Peripheral smears study was done with field A and B stain and leishman stain.
Conclusion-Males are more affected than female, highest prevalence of HIV infection is found in both sex 30-41 years of age group. Anaemia is most common haematological parameters of HIV positive cases. Normocytic normochromic anaemia is most common type of anaemia because HIV is a chronic disease. Second most common finding is microcytic hypochromic anaemia in our study due to poor nutrition and viral effect on fe metabolism Third most common finding is macrocytic anaemia probably due to Zidovudine therapy. Normocytic normochromic anaemia is more common in male but microcytic hypochromic anaemia is more common in female and microcytic anaemia is near equal in both sex
Title: Evaluation of Aerobic Bacterial Isolates and its Drug Susceptibility Pattern in Orthopaedic Infections
Authors: Vishwajith, Anuradha.K, Venkatesha.D
Orthopaedic infections are associated with a high morbidity, often require an aggressive antibiotic therapy, so increased substantial cost. Bone infections remains a serious therapeutic challenge and and increasing resistance has complicated management of these infections. Delayed or ineffective treatment causes significant morbidity in terms of pain, loss of function and the need for further surgery and antibiotics.
To study the aerobic bacteriological spectrum and antibiotic susceptibility pattern of isolates of orthopaedic infections
Materials And Methods
We performed a retrospective review of clinical and microbiological data sets using the access database of patients admitted in orthopedic ward for one year.
Out of 98 samples, 72(73.46%) yielded pure growth, 21(21.42%) mixed growth, 5(5.1%) showed no growth. Out of 115 bacterial strains isolated 56(48.69%) were Staphylococci and 59(51.3%) were Gram negative bacilli.
Among the Staphylococcus spp, MRSA(50%), MSSA(33.9%), MSCONS (9%) and MRCONS(7.1%). Susceptibility pattern of MRSA isolates were 68% to cotrimaxozole, 43% to clindamycin,29% to erythromycin, 18% to gentamycin and all MRSA strains were sensitive to Vancomycin and Linezolid.
Among Gram negative bacilli, Pseudomonas(25.4%), Escherichia coli(22%), Enterobacter (22%), Klebsiella (15.3%), Citrobacter (8.4%), Acinetobacter (3.3%) and Proteus (3.3%). Pseudomonas strains showed100% sensitivity to imipenem, 87% to piperacillin-tazobactum,73% to amikacin,66% to cefotaxime,47% to ciprofloxacin,27% to gentamycin.
Knowing the prevalence and the antibiotic susceptibility pattern of the isolates, helps us to guide the clinician to select the most appropriate antibiotics thereby preventing indiscriminate use of antibiotics.
Keywords- orthopaedic infection, antibiotics, drug resistance, MRSA, Gram negative bacilli.
Title: Association of Hyperuricemia and Dyslipidemia- A Potent Cardiovascular Risk Factor
Authors: Deepti A. Lokanath, Sharada A. Chandrashekariah
Hyperuricemia is becoming a universal risk factor for CVD complications as it is associated with dyslipidaemia, obesity, hypertension and metabolic syndrome. India is a country with variations of culture, life style, food habits and epidemiological report on CVD risk factor may alter in different geographical areas. Hence the present study was on Kodavas, a minority community mainly living in Coorg district of Karnataka. They are now distributed to other places in India and abroad. Ethnic Kodavas have high prevalence of CVD risk factors as they consume diet rich in fat, meat along with alcohol. The investigation was carried out on kodavas living in Mysore Karnataka. Out of 418 subjects enrolled in the study, 28.94% of subjects suffered from hyperuricemia condition and men were affected more than women. High LDL and Hypertriglyceridemia were more prevalent in hyperuricemics. The subjects with both dyslipidemia and hyperuricemia had significant increased levels of novel CVD markers like Lp(a),homocysteine, ApoB and ApoB/ApoA1 ratio(P Keywords: ApoA1, ApoB, Dyslipidemia, Homocysteine, Hyperuricemia, Lp(a)
Title: A Rare Case of Ataxia Telangiectasia with Pulmonary Tuberculosis
Authors: Fairy Susan Varghese, Nilamadhaba Panda, Sunil K Agarwalla
Ataxia Telangiectasia (A-T, Louis Bar syndrome)is a rare autosomal recessive multisystem disorder caused by a mutation in the ATM gene located at 11q22-q23, involved in DNA repair and cell-cycle regulation. The diagnosis of A-T is based on the typical clinical picture-ataxia and telangiectasias. However the definitive diagnosis is by identification of the mutated ATM gene with supportive evidence of raised alpha-feto-protein(AFP) and reduced IgA fraction. Recurrent sinopulmonary infections are common affecting 90% of patients and usually results in chronic bronchitis, bronchiectasis or both. Here we report a rare association of pulmonary tuberculosis with A-T. This 11 year old female had typical clinical features of ataxia and telangiectasia with elevated AFP (254ng/ml) and reduced IgA (<10mg/dl).Sputum for AFB was positive with radiological findings suggestive of pulmonary tuberculosis .Because of the rarity of A-T in India, we report this case to help pediatricians make an early diagnosis.
Keywords- Ataxia telangiectasia,DNA repair,sinopulmonary infections,pulmonary tuberculosis,ATM gene
Title: Study of Vitamin D Deficiency in Patients with Diffuse Body Pains
Authors: S.Mujaheeda Fatima Sara, B.Solomon Sunder Raj, DR. V. Sarath Chandra Mouli
Vitamin D deficiency continues to be worldwide threat, especially in developing countries. It is very much prevalent in the community. It is well known that Vitamin D deficiency causing Rickets in children and Osteomalacia in Adults. With the change in our life style and confining ourselves more to indoors the Vitamin D deficiency is again coming into the lime light . In the present study we have estimated various parameters like serum of vitamin D, calcium, phosphorus, alkaline-phosphatase and parathyroid hormone in normal healthy human volunteers as well as diffuse body pain patients (DBP). About 459 patients, 150 patients were identified as vitamin d deficiency with diffuse body pains and among them 101 were females is enrolled in the study.
Title: Spindle Cell Carcinoma: A Rare Malignant Transformation in Neurofibromatosis (NF1): A Case Study
Authors: Dr.Rahul Bhargava, Dr Pradeep Soni
Neurofibromatosis (von Recklinghausen disease) is an autosomal dominant disorder that occurs about once in three thousand live births. Patients with NF1 have an increased risk of developing malignant tumors, in particular a tendency for some NFs to undergo malignant transformation to a malignant peripheral nerve sheath tumor (MPNST). The reported incidence of malignant transformation of neurofibromas in this condition ranges between 2.4%' and 16.5%. We report a patient in which this malignant transformation was observed to occur in to spindle cell carcinoma which is very rare and not yet reported. Spindle cell carcinoma (SpCC) or sarcomatoid carcinoma is a highly malignant variant of squamous cell carcinoma. It is a rare tumor with a reported incidence of 2% to 3% of all cutaneous cancers.
Keywords- Neurofibromatosis, von Recklinghausen disease, malignant transformation of neurofibroma, Spindle cell carcinoma, squamous cell carcinoma, sarcomatoid carcinoma,
Title: A Review on Recent Advances in Drug Development and Pharmacotherapeutic Approaches for Obesity
Authors: Ayesha Siddiqua, Madiha Ahmed, Venkata Sravani Polamraju , S.Mujaheeda Fatima Sara, Jyothi Aanchal
Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI) . A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight.
Obesity is a well-established risk factor for hypertension, hyperlipidemia, type II diabetes, coronary heart disease, stroke, obstructive sleep apnea, asthma, orthopedic disorders, and certain cancers. Despite this risk, the prevalence of obesity continues to increase worldwide, and there is a growing demand for safe and effective antiobesity drugs. Previous antiobesity drugs or anorexigens, particularly centrally acting agents, have poor safety records. Life-threatening safety issues led to the withdrawal of aminorex in 1968, fenfluramine and dexfenfluramine in 1997, and phenyl propanolamine in 2000. Many of the safety issues, such as valvulopathy with fenfluramine and pulmonary arterial hypertension with aminorex, were initially not predicted by routine preclinical toxicology studies. . Meridian(Sibutramine ) was approved by FDA in 1987,Xenical (orlistat) was approved by FDA in 1999, Recently Qsymia (phentermine & topiramate), Belviq(lorcaserin) was approved by FDA in 2012. This review covers the current state of antiobesity drugs and their safety concerns, and highlights new therapeutic targets and also highlights the threats associated with the surgical treatment of obesity as how liposuction surgery recently claim life of JNTU assistant professor.
Title: Negative Pressure Wound Therapy: A Promising Weapon in Thetherapeutic Wound Management Armamentarium
Authors: Dr. Ketan Vagholkar
Management of infected non healing wounds or the classically described hard to heal ulcers continue to pose a challenge to attending surgeon. Newer methods are being evolved to meet the challenge. The concept of negative pressure wound treatment or vacuum assisted closure is an innovative method. The mechanism of action, methodology and clinical applications are presented in this paper.
Key words: negative pressure vacuum assisted wound treatment
Title: Comparative Study of Hemodynamic Responses to Airway Maintenance Devices: Proseal LMA V/S IGEL Airway
Authors: Dheer Singh, Urvashi Yadav, Manoj Kumar, Prashant K. Mishra
Hemodynamic stress responses to tracheal intubation can precipitate adverse cardiovascular events in patients. In principal, techniques that avoid or minimise oropharyngolaryngeal stimulation might attenuate the hemodynamic stress response or reduce the incident of airway morbidity. We compared hemodynamic responses in 60 anaesthetized, paralyzed ASA-I and ASA-II patients among two airway maintenance devices: Proseal LMA (PLMA) and IGEL airway. Mean duration of insertion in each case of both groups was noted. Patients monitoring done for pulse rate, NIBP, ECG and SPO2 intraoperativly. Mean duration of insertion was significantly shorter in IGEL airway than PLMA. Changes in mean pulse rate were comparable in both groups. In mean arterial pressure, changes were significantly higher in group-I than group-II. No significant complication was noted in either group. It was concluded that IGEL is a better alternative airway maintenance device than PLMA because of ease of insertion and maintenance of hemodynamic stability.
Keywords- Proseal LMA, I-GEL, Hemodynemic responses.
Title: Malocclusion of Permanent Teeth in Primary School Children (6-12 yrs) is a Risk Factor for Caries Teeth
Author: Dr. A. Kasthuri, Dr. K. Mohanakrishnan
Dental health is a part of school health services. Dental caries and peridontal disease are the two common dental diseases in India. Prophylactic cleansing is of great value in preventing gum diseases and in improving personal appearance and personality development. In developed countries, dental hygienists’ are employed in schools to assist the school dentist in the examination of teeth.
Aim and Objectives:
1. To study prevalence of malocclusion in school children of urban and rural children
2. To study the prevalence of caries in primary school children with malocclusion
Rural Government primary school: 400 out of 456 primary class children in the age group of (6-12 yrs.’) of rural government primary school have participated in the study. Mean age of the students was 8.2 yrs. Malocclusion is found in 11%. Prevalence of caries in these children is 95%
Urban school: 350 out of 367 primary school children assessed. Mean age of students was 7.9 yrs. Malocclusion is found in 7%. Prevalence of caries in these children is 90%
Prophylactic dental health check-ups: None of the rural school children had undergone any prophylactic dental health check-ups and 15% the urban children had undergone any prophylactic dental health check-ups in less than a year. (p< 0.001). Mal alignment is found in 11% in rural area and 7% in urban area.
Title: Quantitative Assessment of Pubertal Development among Rural and Urban Adolescents in Osun State, Nigeria: A Comparison of Two Standard Instruments
Authors: Adedayo Sabageh, Adesegun Fatusi, Jerome Elusiyan, Donatus Sabageh, Oluwatosin Adeoye
Introduction: Pubertal development is a critical element in adolescents’ life and is affected by several factors. Studies with quantitative assessment of pubertal development of Nigerian adolescents are rare. Concerns about valid and practical assessment of pubertal development have led to the development of several instruments, but the possibility of differences in the rating of the instrument exists. This study compared the pubertal development of rural and urban school-based adolescents in Osun State, Nigeria, using two widely known instruments – the Pubertal Developmental Scale (PDS) and the Sexual Maturity Scale (SMS).
Methodology: The study involved 760 adolescents who were randomly selected through a multistage sampling process from rural and urban secondary schools in Osun state, Nigeria. Data were collected through assisted self-completion questionnaire method, with the research instrument incorporating both SMS and PDS. Data were analyzed using SPSS version 16. Agreement between the pubertal rating of the instruments was determined using Kappa statistics. Comparing of the pubertal rating of adolescents from urban and rural schools were assessed using Chi-square. Statistical significance was set at the 5% level.
Results: A total of 389 (51.2%) were males and 371 (48.8%) were females, and half of the participants were from rural areas. The mean age was 14.62 ± 2.39 years. Using PDS, the highest proportion of the participants in both urban (32.6%) and rural areas (35.8%) were in the mid-puberty stage, whereas using SMS, the highest proportion of adolescents were in the late puberty (urban: 36.1%; rural: 32.9%). The level of agreement between PDS and MSMS pubertal rating was poor (Kappa Statistic=0.235).
Conclusion: There is a difference in pubertal development of rural and urban school adolescents in Osun State with urban ones attaining puberty earlier. Careful choice of pubertal assessment instruments in clinical practice and adolescent research is warranted in view of the poor agreement between their ratings.
Keywords: Adolescent, puberty, development, pubertal developmental scale, sexual maturity scale
Title: Curvularia A Most Common Missed Occulomycosis in Ocular Trauma
Authors: Dr.Sunay Sudhir Wanmali, Dr.Neena N. Nagdeo, Dr.Vilas R. Thombare, Dr.Hema Mathurkar
Curvularia keratitis typically presented as superficial feathery infiltration, rarely with visible pigmentation that gradually became locally suppurative. Smears of corneal scrapings often disclosed hyphae, and culture media showed dematiaceous fungal growth within 1 week. Natamycin had excellent in vitro activity and led to clinical resolution with good vision in most patients with corneal curvulariosis. Curvularia is a most common oculomycosis isolated in ocular traumas especially when the trauma is due to wooden or plant materials. Being, a most common laboratory contaminant, the patience required to maintain aseptic measures in the clinical microbiology laboratories and identification of the fungus on the basis of microscopic characteristics can help from not missing the diagnosis of Curvularia like oculomycosis and thus saving the critical time in management of corneal ulcers.
Keywords- Curvularia, Occulomycosis, Monomorphic,
Title: Preterm Prelabour Rupture of Membranes at 34-37 Weeks’ Gestation: Intentional Delivery Versus Expectant Management
Authors: Titol Biswas, Souvik Kumar Das, Sarmila Kundu
OBJECTIVES: In this prospective study we wanted to prove that intentional delivery as compared to expectant management for PPROM at 34 – 37 weeks’ gestation will be associated with improved maternal and perinatal outcome.
STUDY DESIGN: Consecutive 100 gravid women at >34 weeks 0 days and <36 weeks 6 days of gestation attending the labour emergency with PPROM fulfilling the selection criteria taken for study. They were randomized to receive misoprostol induction (n=50) or expectant (n=50) treatment only.
RESULT: In this study 12% women of expectant group developed chorioamnionitis and no chorioamnionitis occurred in any women Of induction group (12% vs. 0%, p=0.0353). Maternal hospital stay was significantly prolonged among patients in the expectant group (7.98±5.71 days vs. 3.28 ± 1.98 days, p=0.0001). Rate of Caesarean Section was more in induction group (16% vs. 10%, p= 0.5536). Birth asphyxia (A.S < in 1 min) was more common in expectant group (14% vs. 10%, p=0.095), and neonatal sepsis also more common in expectant group (12% vs. 2%, p=0.1169).
CONCLUSION: In women whose pregnancy is complicated by PPROM at 34 weeks 0 days to 36 weeks 6 days, our study indicates that intentional delivery by induction of labour substantially improves pregnancy outcomes compared with expectant management.
Key words- Chorioamnionitis, Neonatal sepsis, Premature rupture of membranes.
Title: Evaluation of Oral Ketamine for Pain Relief During Perineal Repair in Postpartum Women South-East Nigeria
Authors: Okorie O, Babah OA
Background: We evaluated the efficacy of oral Ketamine for pain relief during perineal repairs in postpartum women with episiotomies, perineal tears and cervical laceration.
Method: A prospective, non-placebo, single blind randomised study was carried out. Two hundred and seventy three (273) booked parturients in active phase of labour were randomly assigned to three treatment groups (A-C). The dosages of oral Ketamine that they received were as follows: Group A- 4 mgkg-1; group B- 5 mgkg-1; and group C- 6 mgkg-1. Of the 273 parturients that received the oral ketamine, 111 of the parturients had perineal laceration and/or episotomy. The efficacy of the drug for suturing episiotomy and vaginal laceration was determined by suturing without infilteration of local anaesthetic (Lidocaine) and assessed for pain using pain assessment tools (visual analogue scale, VAS and verbal rating scale, VRS). Patients with VAS ≥3 and VRS≥3 were infiltrated with 2% Lidocaine with adrenaline (1-7mgkg-1 as rescue analgesia during episiotomy and vaginal laceration repair.
Result: The proportion of women who reported satisfaction to varying degrees during repair of their perineal laceration and/or episiotomy was 66.7% in group A, 42.9% in group B, and none in group C. Rescue analgesia was required in 92.3% of patients in group A, 90.5% for those in group B and 58.3% for those in group C
Conclusion: The higher the dose the better the analgesia during the perineal repairs. However the dosage should be adjusted such as to minimize the incidence of side effects and improve patient’s satisfaction. Probably if the half dose of oral Ketamine that gave maximum satisfaction (4mgKg-1) is given 15 minutes before the procedure, then this might minimize the need for rescue analgesia. This however calls for further studies.
Key words: Analgesia, Efficacy, Oral Ketamine, Perineal laceration
Title: Detection of Isoniazid Induced Hepatitis after 12 Weeks and Its Management
Authors: Dr. Jitesh Dhingra, Dr. Sanjay Rajpal, Dr. K.K Chopra
Hepatotoxicity is a common complication of anti-tuberculosis therapy ranging in severity fromasymptomatic elevation of hepatic transaminases to hepatic failure necessitating liver transplantation. Thistoxicity is caused by most anti-tuberculosis drugs but appears to represent an idiosyncratic response and isusually seen in the first six weeks of starting anti-tuberculosis treatment (ATT) mainly due toIsoniazid(INH) and Rifampicin. The hepatotoxicity seen after twelve weeks is majorly due to Pyrazinamide.However sometimes Isoniazid can be an offending agent after 12 weeks.
Title: The Pattern of Childhood Epilepsies at National Hospital Abuja Nigeria
Authors: Dennis R. Shatima, Chidi C. Ulonnam
Aims: we aim to investigate the pattern of childhood epilepsies in a tertiary hospital in the federal capital city of Nigeria.
Settings and Design: retrospective descriptive study
Methods and Material: The folders of children managed for epilepsy at the Paediatric Neurology Clinic of NHA over a period of five years(August 2009 to July 2013) were retrieved and relevant socio-demographic and clinical information extracted and retrospectively analyzed.
Results: 226 subjects met the criteria for inclusion and were analyzed. The children were between the ages of 1 month to 17years. 157(69.5%) were male. 155(68.6%) were of upper social class. 32(14.2%) patients had positive family history of seizure disorder. 207(91.6%) were diagnosed of generalized seizure. Of the etiology of the seizure; in majority, no factor was identified while brain anoxia and brain infection were the commonest identified causes. 219(96.9%) patients showed abnormal EEG recording while in 75(33.2%) had brain MRI abnormality.160(70.8) patients had AED switched to a different anticonvulsant for various reasons. 41(18.1%) patients had there drug changed once, 2(0.9%) patients had drug switched twice, while 117(51.8%) had drug substituted more than twice. 33(14.6%) patients are on AED polytherapy. 31(13.7%) patients had been seizure free for more than two years.
Conclusions: The study reviews the pattern of occurrence of epilepsy in NHA. Two common etiologies identified were brain anoxia and brain infection. Majority of the patients were observed to have intractable seizure which calls for a need to review the factors that favor poor control in the subjects.
Keywords- childhood, epilepsy, seizure, etiology, intractable, EEG, brain imaging, AED – antiepileptic drugs
Title: Immunoglobulin GM and KM Allotypes Influence on the Outcome of Hepatitis C Virus Treatment
Authors: Manal Zaghloul Maharan, Nesrine A Mohamed, Wesam A. Ibrahim
HCV is an endemic problem in Egypt with genotype 4 affecting about 90% of the infected patients. The treatment with interferon and ribavirin is costly and has various side effects, so there is an urgent need for predictors of interferon response. IL-28B genotype was confirmed as a predictor of response to interferon treatment , but there are need for other predictors. Patients and methods: DNA samples from 100 patients with chronic hepatitis C were allotyped for alleles at two GM loci: GM3/GM17, GM23+/GM23- and the KM locus: KM1/KM3, using PCR amplification, restriction analysis and sequencing. Aim of the study: To detect immunoglobulin GM and KM allotypes—genetic markers of γ and κ chains, respectively—in patients with hepatitis C virus and to assess their influence on the outcome of chronic hepatitis C treatment. Results: There was a significant association between the KM genotypes and the treatment outcome. KM homozygosity is associated with six fold increase in response to treatment. Conclusion: KM genotypes can be used as a marker for prediction of chronic HCV treatment outcome.
Keywords — KM, GM, κ and γ chain antigenic determinants, Ig allotypes, HCV, interferon predictors
Title: Effect of Laparoscopic Roux-En-Y Gastric Bypass on Metabolic Syndrome and GLP-1 Hormone
Authors: Alaa Abbass Moustafa, Mohamed El-Shinawi, Islam Hossam el Din, Reda AbdelTawab, Randa Reda, Rania H El- Kabarity, Nesrine A.Mohamed
Background: An enlarged incretin response after Roux-en-Y gastric bypass (RYGBP) has been proposed to promote weight loss and obesity-related comorbid conditions amelioration especially type 2 diabetes mellitus (T2DM). The dramatic amelioration of T2DM following RYGBP could be accounted for by changes in glucagon-like peptide-1 (GLP-1) secretion. The objective of the study is to evaluate the effect of RYGBP as a metabolic surgery on metabolic syndrome parameters and on fasting serum GLP-1 after one year in 30 patients with BMI of 35-39 Kg/m2. This aimed to prove that a metabolic surgery should be able to resolve one or more of the metabolic syndrome parameters without causing any undue weight loss.
Methods: The selected group of patients had different degrees of glucose tolerance: normal glucose tolerance (NGT, n=9), impaired glucose tolerance (IGT, n=9), and type 2 diabetes (n=12). This study was done to determine the changes of GLP-1, BMI, insulin resistance before and 1 year after RYGBP.
Results: A high significant increase in serum GLP-1was recorded in the three included groups. Moreover, high significant decrease in fasting glucose from 145.3 to 99.2 mg/dl ,associated with significant decrease in fasting insulin from 16.1to11.3 µIu/liter, in all these three groups ,postoperatively, along with a high significant decrease in Homeostasis Model of Assessment - Insulin Resistance(HOMA-IR). All other metabolic syndrome components improved significantly postoperatively, including dyslipidemia, hypertension, and obesity.
Conclusion: Our study supports that RYGBP is associated with alterations in glucose kinetics leading to improvement of type II DM. We consider RYGBP as a proposed treatment for type 2 diabetes.
Title: Serum Angiopoietin-2 and Soluble Thrombomodulin in Patients with Systemic Lupus Erythematosus and their Relation to Disease Activity and Renal Affection
Authors: Salwa Ibrahim Bakr , Abeer Al-Sayed Shehab , Dina El Shennawy , Rania Ahmed Abo-shady, Yasser Ahmed Zeitoun, Noha Hussien Shedid
Background: Several lines of evidence demonstrate excessive endothelial activation in systemic lupus erythematosus (SLE). Angiopoietin-2 (Ang-2) and soluble thrombomodulin (sTM) are two biomarkers of endothelial cell activation that may be clinically useful in SLE.
Objective: to examine the clinical utility of two proposed biomarkers of endothelial activation; angiopoietin-2 and soluble thrombomodulin in SLE correlating their serum concentration with disease activity and renal affection.
Subjects and methods: Ang-2 and sTM were measured in sera obtained from 60 patients with SLE (6 male patients and 54 female) and 30 healthy controls by ELISA methodology. Disease activity was calculated according to the SLE Disease Activity Index (SLEDAI). Patients were classified according to disease activity and renal involvement.
Results:Both Ang-2 and sTM concentrations were increased in patients with SLE in comparison to controls (P<0.001). Both Ang-2 and sTM were significantly higher in the active group and active nephritis subgroup in comparison to inactive group and active patients without nephritis, respectively (P<0.001). Both markers were positively correlated with SLEDAI and protein/ creatinine ratio. Serum Ang-2 was superior to serum sTM as predictor of SLE activity and discriminator of lupus nephritis
Conclusion: Elevated concentrations of circulating sTM and Ang-2 can serve as biomarker of disease activity and renal affection in SLE. Serum Ang-2 was superior to serum sTM as predictor of SLE activity and nephritis. Further studies should be conducted to put serum Ang-2 as a candidate drug target where functional blockade could seem to protect against endothelial damage in such disease.
Key words: Systemic lupus erythematosus, angiopoietin-2, soluble thrombomodulin, SLEDAI.
Title: A Profile Study of Patients with Periarthritis Shoulder
Authors: Arul Pragassame S, Mohandas Kurup V K
Background: Periarthritis (PA) shoulder is a common disabling condition of shoulder. The clinical presentation of illness and factors influencing this condition need to be studied meticulously, This evaluation is pre-requisite for effective planning and implementation of rehabilitation program. Objective: To examine the profile of patients with PA shoulder and to identify the possible factors influencing this disabling condition.
Methods: The study was conducted in the Division of PM&R, RMMCH at Annamalai University. Evaluation of pain and shoulder abduction active range of motion (AROM) was performed. Further, the presence of comorbid conditions, type of occupation, duration of illness and demographic factors were examined by collecting history and through basic investigation procedure.
Results: Total number of patients was 78 (Male-49, Female-29). 52.6% (N=41) of patients had age range of 46-55 years. The majority of women patients were housewives 75.9% (N=22) and about 30.6% (N=15) of men were agricultural workers. 35.9% (N=28) of patients had diabetes mellitus and 17.9% (N=14) of patients had cervical spondylosis. The other finding is that 23.1% (N=18) of patients had more than one associated comorbidities. 55.1% (N=43) experienced moderate level of pain and 32.1% (N=25) of the study patients had shoulder abduction AROM of 140°-159°. Further, it is observed that there was significant association observed for duration of illness Vs severity of pain (P=0.001) and shoulder abduction AROM Vs severity of pain (P=0.009).
Conclusion: The common age of occurrence of PA shoulder is between 46-55 years. Male patients were higher in number. Dominant shoulder was more commonly involved. Majority of patients were agricultural workers, manual labours and house wives. Patients are commonly associated with Diabetes Mellitus. Most of the patients are experiencing moderate level of pain and shoulder abduction AROM is between 120°-159° for majority of patients. There is positive association for duration of illness Vs severity of pain which further states that pain is higher in early stage of PA shoulder. Similarly there is positive association for shoulder abduction AROM Vs severity of pain that is shoulder AROM is limited when pain is higher and vice versa.
Keywords -Comorbidities, Demographic factors, Periarthritis shoulder, Shoulder abduction
Title: Study on Prevalence and Patterns of Dyslipidemia among Kodavas
Authors: Deepti A. Lokanath, Sharada A.Chandrashekariah
Cardiovascular diseases are increasing and dyslipidemia is an important cause. Therefore, it becomes very essential to study these risk factors in the Kodava community, which has been ignored and seem to be predisposed to it due to their life style and food habits. Methods: A cross sectional study was designed by conducting ten health camps in and around Mysore. Around 418 subjects (194 men and 224 women) participated in the camps conducted from 1st March 2012 to 31st January 2013. Informed consent forms were signed by all participants and were asked to answer a standardized questionnaire. Plasma samples were analysed for serum lipid profile [(triglyceride, total cholesterol, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C)] and fasting plasma glucose. Anthropometric measurements and blood pressure was recorded. Results: This ethnic group has presented a clinical picture wherein 88.99% of subjects suffer from one or the other form of lipid abnormality. Dyslipidemia was prominently seen in the 41-60 age group subjects; however 25- 40 age group with normal BMI and low body fat percentage also showed high LDL-C and low HDL-C levels. Conclusions: High prevalence of dyslipidemia was observed among the Kodavas and other factors like obesity, diabetes and hypertension magnified the risk of CVD and other metabolic complications. Life style modification and regular health check-up is crucial.
Keywords-Dyslipidemia, HDL-C, LDL-C, Mixed Dyslipidemia, Atherogenic Dyslipidemia
Title: Prevalence of Orofacial Defects Due to Familial Aggregation, at Tertiary Care Centre in Chennai- A Cross Sectional Study
Author: Sushmitha Baskar
Both cleft lip and cleft palate are orofacial birth defects. A cleft lip may be just a small notch in the lip. It may also be a complete split in the lip that goes all the way to the base of the nose.A cleft palate can be on one or both sides of the roof of the mouth. It may go the full length of the palate .Though orofacial defects, such as cleft lip and cleft palate, are corrected by surgical methods, they do leave behind marks of their occurrence. This causes various complexity problems for patients in society. By doing this study, we will come to know incidence of orofacial defects by familial aggregation due to consanguineous marriages, i.e. marriages within relations. This can be further classified as first degree consanguineous marriage, that is marriage between immediate relations (eg. between brother and sister), then second degree consanguineous marriages, i.e. marriages between first cousins and so on. In this study, we will also come to know the extent of occurrence of these defects in family, i.e. we check if patient’s siblings are also suffering from any kind of these defects. The motive of this study is to create public awareness in mind of people about consanguineous marriages and their effects in form of familial aggregation. Further, this study can be carried out by checking the incidence of these orofacial defects in future generations and checking out rate of incidence of these defects when the patients married within relation and outside the relations. Moreover, by creating public awareness related to this issue, we can prevent future generations from these defects and prevent various kinds of complexity problems.
Keywords- Orofacial Defects, Familial Aggregation, Consanguineous Marriages, Chennai
Title: Fetal Cerebral Umbilical Doppler Ratio in Prediction of Adverse Perinatal Outcome in Patient with Preeclampsia
Authors: Dr. Souvik Kumar Das, Dr. Titol Biswas
Objectives: This study was undertaken to evaluate the role of middle cerebral to umbilical artery blood velocity waveform's systolic/diastolic ratio (MCA/UA) and compare with biophysical profile as a predictor of adverse perinatal outcome in a patient complicated with pre eclampsia.
Methods: In this prospective cross sectional study 100 gravid women complicated with preeclampsia in 3rd trimester fulfilling the selection criteria was taken for study. Thorough history taking with general, obstetric and pelvic examination & routine and special investigation was done. The periodic follow up was performed using non Stress Test (NST), amniotic fluid index (AFI ), umbilical artery resistance index (UARI), middle cerebral artery resistance index (MCARI) and MCA/UA ratio. MCA/UA <1, non reactive NST, AFI <5 were considered abnormal. The results of the ratio, and biophysical profile were evaluated to find out the best predictor of adverse perinatal outcome (APO) defined as perinatal mortality, caesarean delivery for fetal distress, admission to the neonatal intensive care unit (NICU), Apgar score <7 at 5 minute.
Results: Among all the antepartum surveillance tests, MCA/UA Doppler ratio had found the highest sensitivity ( 72.97%),
specificity 95.24%), Positive Predictive Value (PPV) (90%), Negative Predictive Value (NPV) (85.71%) for prediction of adverse perinatal outcome in pregnancies complicated with pre eclampsia.
Conclusions: The MCA/UA was found the best predictor of adverse perinatal outcome in patients complicated with pre eclampsia. When the ratio was <1, fetal prognosis was poor.
Key words: Doppler, preeclampsia, middle cerebral artery, umbilical artery.
Title: Status of Small Dense LDL in Fasting and Nonfasting Lipidemia in Coronary Heart Disease
Authors: Pranshi Mishra, Neelima Singh ,Puneet Rastogi
LDL consists of heterogeneous spectrum of particles with highly variable atherogenic potential i.e. small dense LDL. The atherogenicity of sdLDL is due to its high oxidizability, owing to low cholesterol and high PUFA and Apo B content. Since, small dense LDL whose half life is more than LDL-C in plasma, is coming up as new marker for CHD diagnosis. Hence, we aimed our study to know the status of sdLDL along with other lipid parameters in nonfasting condition.The present study comprised of fifty clinically diagnosed cases of CHD admitted in ICU of J.A.group of hospital and fifty age and sex matched healthy individuals were considered as control subjects. Their fasting and nonfasting samples were analysed for lipid profile. There was a significant change in all the lipid parameters in nonfasting condition but small dense LDL varied minimally.On account of the small variation in the levels of sdLDL in fasting and nonfasting state, compared to the other lipid parameters which show greater variability in both states, this small dense LDL can be a better marker for the diagnosis of coronary heart disease
Authors: Venkata Sravani Polamraju , Ayesha Siddiqua, Khaja Ramizuddin Mahammad, Lakshmi Sivasubramanian, Daya Sagar Rao V
The incidence of ACS is rapidly increasing in India & causing high mortality. In the treatment pattern of ACS & PTCA, antiplatelet agents are prescribed as a part of maintenance & prophylactic therapy. Ticagrelor, a newer non-thienopyridine & first reversibly binding oral P2Y12 platelet inhibitor, provides faster, greater & more consistent platelet inhibition than clopidogrel. It is proved by the PLATO trials that it is more potent among anti platelet therapy used in ACS & PTCA patients. The utilization rate of various antiplatelet agents like Aspirin, Clopidogrel & Prasugrel compared to Ticagrelor in the common clinical practice was studied .The effect of contraindications, cost & Physician’s preference related aspects play an important role in prescribing Ticagrelor in the ACS & PTCA patients, reasons for its poor usage in common clinical practice was studied.
Key words: PLATO (Platelet Inhibition and Patient Outcome); Acute Coronary Syndrome (ACS); Percutaneous Transluminal Coronary Angioplasty (PTCA).
Title: Comparative Evaluation of Variation in Heart Rate Variability with Change in Posture in Young Adult Indian Males and Females
Author: Dr. Sanhita Rajan Walawalkar
Context: An important component of Cardiovascular Adaptation is the ability of the cardiovascular system to adapt to physiological changes caused by physical challenges such as change in posture, gender etc, causing its adaptation response. If these parameters remain within sub- normal range for a long duration, then this could mean a sign of cardiovascular dysfunction, which may point toward poor physical health or onset of a cardiovascular disorder. Heart rate variability (HRV) is an important and widely-used measure of autonomic functioning, especially to assess cardiac activity. Few studies have focused on the impact of change in posture and gender on cardiac autonomic modulation in Indian context, so the rationale behind the present study was to systematically investigate the effect of postural change and gender on various HRV parameters using frequency domain measures of HRV in healthy young adult Indian population.
Aim: To record, compare and evaluate HRV in different postures in young adult Indian males and females.
Settings and Design: The study was conducted on 100 young adults (50 males and 50 females).
Methods and Material: Their Height, Weight, Pulse rate & Blood Pressure were noted.HRV was recorded with the help of Anu photo rheograph using frequency domain method in supine, sitting and standing postures.
Statistical analysis used: The data was analysed using SPSS 17.0 statistical package. Comparison between groups (supine, sitting and standing) was done using one way ANOVA followed by Tuckey’s POST HOC test and Independent t-test. The statistical significance level was established at 5% (P < 0.05) and 1% (P < 0.01).
Results: The present study shows that, HRV parameters, such as TP, VLF and LF were higher in males, which reflect sympathetic dominance in males. HF was significantly higher in females, which demonstrates parasympathetic dominance in females. Mean RR interval was significantly higher in males than females in lying and standing position but not in sitting position. With changes in posture (lying-sitting-standing), mean RR interval decreased. Both genders demonstrated significant decrease of mean RR interval with change of posture from sitting to standing, but it was not significant from lying to sitting, which may be explained by increased sympathetic tone with change in posture from sitting to standing.
TP decreased with postural changes in males and females but not significantly. Significant difference in TP between males and females in sitting and standing positions could be explained on the basis of greater parasympathetic dominance in females and greater sympathetic dominance in males. In our study no significant difference in VLF could be observed either with change in posture, or between genders.VLF indicates influence of long-term regulatory mechanisms. So, our study which consisted of short time recordings does not reflect the influence of such mechanisms.
The difference in LF was significant in lying position only. In both genders, there was a significant increase of LF with change in posture from lying to sitting. But with change of posture from sitting to standing, LF decreased not significantly. These findings can be explained by increase of sympathetic tone with lying-sitting change in posture. And decrease of sympathetic influence with sitting-standing change in posture could be related to recovery process trying to find a balance in a new standing condition. The difference in HF between males and females was significant in supine and sitting postures but not in standing position. When postures were changing from lying to sitting and to standing, HF decreased in both sexes. It correlates with decreased parasympathetic and increased sympathetic tone with postural changes from lying to sitting and to standing.
Keywords- heart rate variability, change in posture, gender, young adult Indian males and females, comparison
Title: Giant Phyllodes Tumor Resulting from Gross Negligence (A Case Report and Review of Literature)
Authors: Sanghamitra Jena, Arnab Gupta
Phyllodes tumors are rare fibroepithelial lesions that make up 0.3 to 0.5% of female breast tumors. They are benign in 35-64% of cases and timely diagnosis and surgical intervention gives good results. But lack of knowledge and fear for surgery brings many patients with giant phyllodes tumor in Indian setting. Herein we report a case of a 47 year old lady with diagnosis of benign phyllodes tumor for 20 years and neglecting it, till it grossly enlarged and started bleeding actively. She came with hemoglobin of 3.3g%, but is now doing well after mastectomy. So awareness among the people and proper counselling is required to reduce such cases and their complications.
Keywords-GiantPhyllodes tumor, fibroepithelial lesion, cystosarcoma phyllodes, fungating right breast mass, monoclonal proliferation of stromal Cells
Title: Fulminant Invasive Pulmonary Aspergillosis In Immunocompetent Patients- A Report of two Cases
Authors: Ghosh (Ray) Reena, Banerjee Debarati, Sugata Dasgupta, Dr. Rathindranath Ray, Prof. Tamal Kanti Ghosh
Two cases of invasive aspergillosis (IA) in immunocompetent patients with a fulminant fatal outcome are reported. Both patients had a history of chronic lung disease treated with prolonged corticosteroid inhalation and a short course of systemic corticosteroids. They presented with dyspnea and fever, their respiratory function deteriorated rapidly and they succumbed to the disease. Aspergillus fumigatus was cultured from deep tracheal aspirate (DTA) samples of both patients. In the first case, IA diagnosis was confirmed by thoracic CT scan along with isolation of Aspergillus fumigates in blood culture. These two cases demonstrate that short term systemic corticosteroid therapy in immunocompetent patients with underlying chronic lung condition is a risk factor for IA. Invasive aspergilosis should be suspected in COPD patients receiving steroid treatment who have extensive pulmonary infiltrates in initial chest X-ray. More judicious use of corticosteroids may help prevent occurrances of IPA (invasive pulmonary aspergillosis ) with its attendant serious morbidity and high mortality.
Key-words: Invasive aspergillosis(IA), Aspergillus fumigates,corticosteroids, immunocompetent patients, COPD.
Title: A Comparative Study on the Effect of Honey and Povidone Iodine Ointment on Pain, Wound Healing and Quality of Life of Patients with Varicose Ulcer
Authors: P. Jasmine Parimala, S. Rajina Rani
The present study was aimed to assess the effect of honey and Povidone-Iodine ointment on pain, wound healing and quality of life of patients with varicose ulcer. An evaluative approach, non-experimental comparative study was conducted from September – 2013 to March – 2014 among the 100 patients with varicose ulcer admitted in the Shanthi Hospital, located in Tisayanvilai, Tirunelveli District of Tamil nadu, South India. Purposive sampling was done to choose the study population. The total study population was divided in to two groups of 50 members each. Group – 1 received honey treatment. Group – 2 received Povidone – Iodine ointment 10% w/w (Betadine ointment) treatment. A pre-designed and pre-tested questionnaire was used as a study tool. Initially the demographic data was collected. The details of pain, quality of life and wound were collected before and after treatment. The collected data was analyzed by using statistical package for the social sciences (SPSS) software. The results showed that majority of patients (66%) were male and aged between 45 – 54 years (43%). All the patients were literate. Majority of patients (54%) were married. 35 of 100 patients had smoking habits and 47 of 100 patients had alcohol usage habits. 59 patients having the ulcer for more than five years and 41 patients having the ulcer duration below 5 years. Pain was reduced and the quality of life was improved significantly by both honey and Povidone –Iodine ointment. In the 15th day follow up the net wound healing score of honey was 16.6 ± 3.3. The net wound healing score of Povidone – Iodine ointment in the 15th day follow up was 18.2 ± 3.2. From this study it was clear that the Povidone – Iodine ointment showed a significant wound healing effect and both the honey and Povidone –Iodine ointment showed a significant effect on pain and quality of life. In the future a similar study with larger sample size and longer duration may give more valuable results.
Key words: Honey, Povidone – Iodine ointment, Varicose ulcer.
Title: Cervical Smear Screening Using Cost-effective Liquid Based Cytology
Authors: Lopamudra Das, Phani Krishna Karri, Ashok K. Maiti, Tandra Sarkar, Keya Basu, Sukla Naskar4, Soumen Das, Jyotirmoy Chatterjee
Objective: To minimise false negativity in cervical cancer screening with Papanicolaou (Pap) test, there is a need to explore novel cytological technique and identification of unique and important cellular features.
Method: The present study explores the feasibility of low cost cervical monolayer in comparison to conventional Pap smear and available liquid based cytology techniques in extracting cytopathological features to classify normal and abnormal conditions. Comparative efficacy of newly developed technique to that of commercially prepared one was validated by automated cellular image analysis.
Result: The results show that newly developed monolayer technique for cervical smears was cost effective, capable of better cyto-pathological evaluation and also compatible for automation. The precision and sensitivity were remarkably improved for nucleus and cytoplasm using cost effective monolayer in comparison to other available techniques.
Conclusion: The proposed cost-effective monolayer technology could increase the efficiency of the cervical screening to a greater extent thereby reducing the rates of faulty diagnosis.
Keywords: Cervical cytology screening, Liquid based technology, Automated image analysis, Sensitivity, Accuracy, Precision
Title; A Review Based Study on Acute Coronary Syndrome
Authors: Madiha Ahmed, Ayesha Siddiqua ,Venkata Sravani Polamraju, S.Mujaheeda Fatima Sara, Jyothi Aanchal
Advances in treatment and early revascularization have led to improved outcomes for patients with acute coronary syndrome (ACS). However, elderly ACS patients are less likely to receive evidence-based treatment, including revascularization therapy, due to uncertainty of the associated benefits and risks in this population. Patients presenting with acute coronary syndromes (ACS) remain amongst the highest-risk of all acute medical admissions. Despite significant reductions in morbidity and mortality via refinements in treatment methods in recent years, such individuals remain at a high risk of recurrent ischemic events and death. Whilst 2012 has brought a wealth of novel data in the field of ACS regarding diagnosis and both medical and invasive management strategies, continued focus on this high-risk patient subset is necessary to further our understanding and improve patient outcomes.
This article addresses key issues regarding medical and revascularization therapy in elderly ACS patients based on a review of the medical literature and in concordance with clinical practice guidelines from the American.Heart Association (AHA) and the American College of Cardiology (ACC).
Keywords:acute coronary syndrome, revascularization, medical therapy.
Title: A Study of Thyroid Function in Diabetes Mellitus
Author: Dr. Firdushi Begum
Diabetes Mellitus and Thyroid Disease are two common endocrinopathies seen in adult population of North Eastern region of India. Presence of thyroid dysfunction in Diabetic patients makes management of the disease more difficult. This is a hospital based study done to compare the prevalence and form of thyroid dysfunction in Diabetic patients and non-Diabetic controls. Thyroid Function (TSH, TT3, TT4, FT3, FT4) was studied in 100 cases of Diabetes Mellitus and 100 non-diabetic controls.There was significant difference in TSH levels in between Diabetics and Non-Diabetics (2.94±2.1mIU/Lvs2.18±1.5 mIU/L, p<0.05). TT4 and FT4 levels also showed significant difference in between the two groups,TT4(118.53±54.83nmol/L vs 95.5±26.12nmol/L, p=.0002), FT4 (10.42 ±22.91pmol/L, 14.54±5.28pmol/L, p<.0001). Thyroid dysfunction was found to be 43% in Diabetics as compared to 21 % in non-Diabetics. In Diabetics 35% were hypothyroid and 8% hyperthyroid. 37.29% of female diabetics were found to be hypothyroid as compared to 31.7% of male diabetics.
Diabetes Mellitus, Hyperthyroid, Hypothyroid, TSH (Thyroid Stimulating Hormone), TT4 (Total thyroxine), FT4 (Free Thyroxine), TT3 (Total Tri-iodothyronine), FT3 (free tri-iodothyronine)
Title: LMCA Stenosis Diagnosis in the ER Using the AVR
Authors: Inder Maurya, Garima Malpani, Subuhi Sayed, Amit Nagpal
Electrocardiography continues to be the jugular vein of modern medicine and it continues to be the most frequently ordered test in the Emergency Medicine Department. EKG, as a diagnostic tool is immensely valuable and assists the Emergency room (ER) physicians in diagnosing variety of life threatening conditions from Acute Coronary Syndrome (ACS) to Tricyclic anti depressant poisoning.
We present to you a case report of how EKG helped in diagnosing Left Main Coronary Artery (LMCA) stenosis with 100% block in the ER with help of AVR lead in ACS setting and how prompt diagnosis and activation of Cathlab decreases mortality.
Keywords: LMCA stenosis , ST elevation , AVR lead, Emergent PCI,
Title: Cell Cycle Proteins (NFkB, P53, P21, P27) Determination in Patients Samples with Hodgkin's Lymphoma
Authors: Nidhal Abdul Mohaimen, waleedkhalid, laila Alomer
Background: p53 tumor suppressor pathway and other cell cycle regulatory proteins has been suggested as a candidate pathogenic mechanism in Hodgkin's lymphoma ( HL).
Aim: evaluating the frequency of of expression of the cell cycle proteins including the mutant p21Ras ,NFkB, p53 and p27 proteins in the malignant Hodgkin/Reed-Sternberg cells ( H/RS cells) of HLsamples and seeking correlation between each protein studied.
Methods: A total of 40 archival tissue biopsy samples diagnosed tohave Hodgkin’s lymphoma (HL) were included.
The cell cycle regulatory proteins, NFkB, p53, p27 proteins and the mutant p21Ras oncoprotein were studied using insitu hybridization and immunohistochemistry assays.And study the correlation between p21Ras and each of the NFkB, p53 and p27 proteins.
Results: The frequency of H/RS cells expression of NFkB, p53, p21 and p27 proteins in HD cases were 17 (85%), 19 (47%), 29 (72.5) and 9 (22.5%) cases, respectively . The expression was statistically significant [the corresponding Relative Risk (RR) values were 4.52, 5.43, 3.82, and 0.11respectively ]. All cell cycle markers gave nuclear pattern of staining except p21Raswhich gave clear cytoplasmic staining. Correlation between the cell cycle marker revealed no correlation betweenexpression of NFkB and any of the other markers, p53, p21 and p27(p>0.05). p53 exhibited low but insignificant correlation with p21expression (p>0.05), and no correlation with p27, while a highlysignificant but inverse correlation was found between p21 and p27(p<0.01).
Conclusion: The high expression of the mutant p21Ras and the low expression of p27 both contribute tocell growth and proliferation albeit through different pathways
Key words: Hodgkin’s lymphoma,cell cycle molecules, in situ hybridization, immunohistochemistry
Title: Immunohistochemistry to Detect Ki-67 ,ER and PR in Iraqi Breast Cancer Patients
Authors: Nidhal Abdul Mohaimen, Bushra Madhour, Farouk Hassan
Background: Ki67 (cell proliferation marker) has been attracting a considerable attention as a prognostic factor in breast cancer.
Objective: To investigate expression and significance of ER, PR and Ki67 in breast cancer, and analyze the influence on judging prognosis.
Method: Immunohistochemistry was employed to detect expression of ER,PR and Ki67 in benign lesions of breast(11 cases) and malignant breast cancer(62cases). All cases were admitted to Al-Yarmouk teaching Hospital, Baghdad Medical City,between December 1999-January2001
Results: Positive rates of ER,PR and Ki67 were 27.2%,45.0%,63.6% respectively in benign lesions of breast. Positive rates of the expression of ER,PRand Ki67 in malignant breast cancer were 37.1%,51.6%and 40.3 % respectively. Poorly Differentiated Ductal Carcinoma) PDC (occupied the highest percentage (50%) for expression of ki-67.
Conclusion: The expression rates of ER, PR and Ki67 in cancer are obviously higher than those in non-cancer tissue. In PDC, the expression of Ki67 is higher than any others types of the cancers involved in the study, suggesting that the expression of Ki67 play an important role in malignant transformation of benign lesion of breast. Detection of over expression of all these markers suggests high degree malignancy of the breast cancer.
Key words: Breast tumors,Ki-67, ER, PR, immunohistochemistry
Title: Comparison and Evaluation of Rapid Cold AFB Stain with Ziehl-Neelsen Staining in a Prospective Study
Authors: Sumit Kumar Rawat, Talha Saad
Objective: Correct and rapid diagnosis of the tuberculosis is very important to control the growing epidemic. Its laboratory diagnosis is mainly dependent on the demonstration of acid-fast bacilli in sputum by direct microscopy. Ziehl-Neelson’s staining is traditionally used for detecting tubercle bacilli cold staining methods recently commercially available for use in small and remote setups; however its use and efficacy has not been adequately studied.
Methods: Total 508 consecutive sputum samples both spot and early morning were collected over a period of six months and were stained with both Z-N stain and cold AFB stain and results were compared.
Results: Out of collected 508 samples a total of 203 were AFB positive by Z-N stain and 181 were positive by cold staining method. By comparing the two we get sensitivity of 89.2%, specificity of 100%, false negative rate 10.8% and false positivity of 0% by cold staining method against Z-N stain.
Conclusion: In current scenario usage of cold staining method must be limited to less equipped setups and their results should be interpreted with caution keeping in mind that negative results need to be crosschecked at a better equipped laboratory or a RNTCP center in high suspicion cases.
Keywords:Acid fast bacilli, Z-N staining, Cold staining, Diagnosis of Tuberculosis