Journal of Islamabad Medical & Dental College
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Demographic Profile of Keratinocyte Tumours
Get PDFBackground: Keratinocytic tumours of epidermis constitute the bulk of neoplastic lesions of the skin, and comprise benign, borderline and malignant lesions. Objective: To study the characteristics of keratinocytic tumours in our hospital population and compare the collected local data with the available international data. Materials and Methods: This cross-sectional, descriptive study was conducted in University of Health Science and Mayo Hospital, Lahore from March 2010 to October 2010. A total of 112 consecutive cases of histologically diagnosed keratinocytic tumours were included in the study. Age, gender, histologic types and site distribution of these tumours were recorded and analyzed. Results: Among keratinocytic tumours, basal and squamous cell carcinomas were the most frequent malignant lesions and viral warts were the commonest benign lesion. Males were affected more commonly than females. Patients were in the age range of 13-85 years. Head and neck region was the most frequent site of involvement. Conclusion: The results of the study are comparable with international data regarding age, gender and site distribution of keratinocytic tumours
Validation of Automated ESR Methods with Conventional Method as Gold Standard
Get PDFObjective: To compare the ESR values by VesMatic Easy and Vacuette SRS 20/11 with conventional Westergren method, aiming to validate the automated methods. Material and Methods: A cross-sectional study was conducted at Islamabad Diagnostic centre, Islamabad. A total of 108 blood samples were subjected to ESR estimation by manual Westergren method and by automated (Ves-Matic and Vacuette SRS) methods. Results were analyzed on SPSS ver. 17. Results were compared and their correlation was calculated using Pearson correlation coefficient. Results: There is strong positive correlation between Westergren method and Ves-Matic easy methods with Pearson coefficient of 0.97 and highly significant p value of 0.000. Results also show strong positive correlation between Westergren and Vacuette SRS methods with Pearson coefficient of 0.95 and highly significant p value of 0.00. Conclusion: Both automated methods (Ves-Matic Easy and Vacuette SRS) show good correlation to manual Westergren method, and are reliable and suitable for use in high workload clinical laboratory
Spectrum of Malignant and Non-Malignant Hematological Disorders in a Tertiary Care Centre
Get PDFObjective: To analyze the spectrum of malignant and non-malignant hematological disorders in our setup. Patients and Methods: This cross-sectional study was done in the Department of Pathology, Khyber Teaching Hospital, Peshawar, from 1st January -2016 to 30th December-2016. A total 352 patients underwent bone marrow biopsy during study period. About 15 patients had inadequate aspirate samples that were unfit for opinion. So these were excluded from the study. The remaining of 337 patients were included in the study. All patients of both sexes and all ages were included in the study. Bone marrow aspiration and biopsy was done, the slides were stained, examined and diagnosis was recorded. Data was analyzed by SPSS version 16 and results were drawn accordingly. Results: Among total 337 patients, there were 185 (55%) male and 152 (45%) females. Male to female ratio was 1.2:1. The median age of participants was 26 years and range was 9 months -72 years, (mean age was 36±17.8 years). Regarding pattern of hematological illnesses, commonest non-malignant disorder was Megaloblastic anemia. Among malignant hematological illnesses, frequent disorder was Acute Lymphoblastic Leukemia. Conclusion: Megaloblastic anemia, Hemolytic anemia, and Aplastic anemia are common non-malignant hematological disorders in our setup. Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia and Multiple Myeloma are common malignant hematological disorders in our set up. 
Primary Adenosquamous Carcinoma of Prostate: A Rare Aggressive Tumor
Get PDFAdenosquamous carcinoma is an aggressive tumor of prostate with only 30 cases reported so far in literature. We present a case of this rare entity that was seen in our department. A 70 years old male presented with urinary outflow obstruction and slightly raised PSA levels [5mg/ml (normal; 0-4 mg/ml)]. Transuretheral resection of prostate was done and specimen was sent to our department. Histologically, it composed of both malignant squamous and glandular components. Squamous component showed large tumor cells with abundant cytoplasm and nuclei with prominent nucleoli. Glandular component showed tumor cells arranged in acinar pattern, predominantly in cribriform architecture. As the current guidlines, Gleason grading is not required for adenosquamous carcinoma of prostate. The case was reported as the adenosquamous carcinoma of prostate. This rare tumor has an extremely poor prognosis with most of the patients dying within 1 year of diagnosis
Surgical Scar Breast Carcinoma: A Rare Entity
Get PDFBreast carcinoma is common having many predisposing and genetic causes, however, breast carcinoma of surgical scar is very rare entity. Carcinomatous changes can occur at the site of burns scar, chronic ulcers, fistulous tracts, chronic infections and surgical scars. Here we report the case of 44 years old female patient who underwent surgical excision of Fibroadenoma of left breast and developed mass at the site of previous surgical scar 7 years later, which proved to be carcinoma on radiological imaging and biopsy reports. 
The Relationship of Tinnitus with Cognitive Impairment in Normal Hearing Individuals
Get PDFObjective: To determine the impact of tinnitus on cognitive impairment in normal hearing individuals. Patients and Methods: This cross-sectional study was conducted at the ENT department of Railway Hospital, Rawalpindi from 1st March 2016 to 1st January 2017. A total of sixty (n=60) patients of both gender between age 18 to 50 years, who had normal hearing (clinically examined by tuning fork test and later on confirmed by pure tone audiometry) with history of unilateral or bilateral tinnitus of more than 3 months’ duration were included in the study. Mini mental state examination scale was used to assess cognition. Results: There were 42% (25/60) males and 58% (35/60) females in the study sample. A total of 53.33% (n= 32) patients were identified with impaired cognition, of which 65.62% (n=21/32) patients were found with mild cognition while 34.38% (n=11/32) patients were found to have severe cognitive impairment. Moreover, it was also observed that the cognitive impairment was more prevalent in people of younger age group (P<0.05), office workers (P<0.05) and people living in urban area (P<0.05). Conclusion: A significant percentage of patients with tinnitus of more than 3 months’ duration were found to have impaired cognition and was more prevalent in people of younger age group, office workers and people living in urban areas. 
Diagnostic Accuracy of Trans-Abdominal Ultrasonography in Urolithiasis, keeping CT KUB as Gold Standard
Get PDFObjective: To determine the diagnostic accuracy of trans-abdominal ultrasonography in urolithiasis, keeping CT KUB as gold standard.Material and Methods: This cross-sectional validation study was conducted at Armed Forces Institute of Radiology and Imaging, Military Hospital (MH) Rawalpindi from 15 July 2015 to 14 July 2016. In total 115 patients with expected urolithiasis were evaluated with transabdominal ultrasonography and the findings were documented. CT KUB of these patients was carried out. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of transabdominal ultrasonography were calculated, keeping findings of CT KUB as gold standard.Results: Among total of 115 patients, 54.78% (n=63) were males and 45.22% (n=52) were females. Mean age was 35.69 ± 5.91 years. Frequency of urolithiasis on CT KUB was recorded in 62.61% (n=72). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of transabdominal ultrasonography in urolithiasis was calculated as 65.27%, 72.09%, 79.66%, 55.36% and 67.83% respectively.Conclusion: The diagnostic accuracy of trans-abdominal ultrasonography in urolithiasis is acceptable for diagnosing urolithiasis and hence it may serve as an alternative in case of unavailability or contraindication to CT scan
Anemia of Chronic Diseases
Get PDFObjective: To evaluate the etiology and clinicohematological profile of patients with anemia of chronic disease. Patients and Method: Patients with anemia of chronic disease were included. All underwent bone marrow examination, and bone marrow trephine biopsy, where required. Etiology was elucidated on the basis of clinical history and relevant investigations. Diagnosis of anemia of chronic disease was based on increased iron in fragments with decreased or absent siderocytes and sideroblasts Results: Definitive cause of anemia was not ascertained in 57.1%. In the rest of the cases tuberculosis (17.1%) was the commonest. Majority of the patients (54.3%) were more than 60 years of age. Fever (51.4%) was the commonest complaint. Severe anemia was found in 25.8%. Bone marrow iron stain revealed increased iron in stores with absent siderocytes and sideroblasts Conclusion: A high number of unexplained cases (57.1%) highlights the need to characterize the causes of anemia of chronic disease as treatment of underlying disease will actually improve the hemoglobin concentration in these patients
Frequency of Enteric Gram Negative Rods Isolated from Various Clinical Samples
Get PDFObjective: To determine the frequency of gram negative rods in both nosocomial and community acquired infections in our setting. Material and Methods: This descriptive study was conducted at the Microbiology Department of Fauji Foundation Hospital, Rawalpindi over a period of two years (April 2004 to March 2006). All pus, urine, blood and HVS received during the study period were included. Samples without properly filled forms, dried swabs and improperly transported samples were excluded. Results: Two thousand and ninety one Enteric Gram Negative Rods (EGNR) were isolated over a period of two years. They were most commonly found in urine samples (40.7%), followed by pus (37.1%), HVS (12.0%), sputum (6.12%) and blood (3.92%) samples. The most common EGNR isolated was Escherichia coli (49.7%) followed by Klebsiella pneumoniae (23.4%), Pseudomonas aeruginosa (19.5%) and Proteus species (1.81%). The most commonly isolated Enteric Gram negative rod from urine samples (n 852) was E. coli (622) followed by Klebsiella pneumoniae (189), Providentia (18) and Enterobacter species (13). The most commonly isolated Gram negative rod from pus samples (n 852) was Pseudomonas aeruginosa (290) followed by E. coli (227), Klebsiella pneumoniae (18) and Proteus species. The most commonly isolated EGNR from HVS samples was E. coli (130) followed by Klebsiella pneumoniae (68) and Pseudomonas aeruginosa (51). The most common EGNR found in sputum (n 128) was Klebsiella pneumoniae (56) followed by Pseudomonas aeruginosa (40) and E. coli (30). In blood samples the most common organism isolated was E. coli, followed by Pseudomonas and Klebsiell
Osteopetrosis, a Rare Cause for Bone Marrow Failure
Get PDFOsteopetrosis is a rare genetic disorder characterized by functional defect of osteoclasts resulting in failure of bone resorption, increased bone sclerosis and bone marrow failure. Patients present with stunted growth, skeletal changes, hepatosplenomegaly, features of pancytopenia and characteristic radiological changes. Osteopetrosis has variable inheritance pattern. Diagnosis is made on the basis of history with clinical findings, characteristic radiological and bone marrow findings. We present a case of a 10 years old female child with stunted growth, frontal bossing, teeth abnormalities and characteristic radiological and bone marrow findings