Journal of Islamabad Medical & Dental College
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Bilateral Persistent Hyperplastic Primary Vitreous
Get PDFPersistent hyperplastic primary vitreous (PHPV) is a congenital developmental anomaly of the eye caused by the failure of regression of primary vitreous with the abnormal persistence of hyaloid vasculature. Here we present a case of bilateral persistent hyperplastic primary vitreous (PHPV) which is a rare entity, in a 2 months old infant who presented in our department with history of bilateral microopthalmia and leukocoria. In this regard ultrasound doppler, CT scan and MRI findings of PHPV will be discussed. We suggest that this entity, although rare, should be considered in the differential diagnosis while evaluating bilateral leukocoria. 
Frequency of Benign and Malignant Ovarian Lesions: A Histopathological Analysis
Get PDFObjective: To find the frequency of ovarian lesions in various ages at Pathology Department, ANMC Islamabad Material and Methods: This Cross sectional study was conducted in department of Pathology ANMC Islamabad from 1stJanuary 2015 to 30th June 2016. About 178 cases of ovarian lesions were included in the study. The samples were processed as per recommended steps for histopathological diagnosis. Data was recorded and analyzed by using SPSS version 20. Frequencies for specific diseases were calculated in terms of percentages. Mean and standard deviation were calculated for numerical values. Results: Among 178 ovarian specimens, commonest pathology was non-neoplastic cysts in 78 cases (43.8 %) followed by benign tumors in 74 cases(41.6 %) and malignant tumors in 26 cases (14.6 %). The common lesions were endometriotic cysts 21.3 %, serous cystadenoma 17.4 %, benign cystic teratoma 14 %, follicular cyst 12.3 %, hemorrhagic cysts 10.1% and mucinous cystadenoma 7.3 %. Common malignant tumors were serous cystadenocarcinoma 6.7%, mucinous cystadenocarcinoma 2.8% and endometroid carcinoma 1.7% . Conclusion: Non neoplastic cysts were the most common ovarian lesions (43.8%). This was followed by benign (41/6%) and malignant tumors (14.6%) cases. Surface epithelial tumors were more common than other tumors. 
Management of Ingested Foreign Bodies
Get PDFObjective: To determine the likelihood of spontaneous passage of esophageal coins in stomach, to see the effect of initial coin location on spontaneous passage and to design management strategies. Material and Methods: This prospective interventional study was conducted from March 2011 to March 2016, in the department of ENT POF Hospital Wah Cantt.In all patients of coin ingestion history and radiological findings were recorded. They were evaluated after 24 hours for either spontaneous passage of coin to stomach or needed surgical intervention with either Magill forceps or oesophagoscopy. Base line investigations and repeat X-ray were done before surgical procedure. Results: Out of 25 patients of coin ingestion, 60% (n=15) were boys and 40% (n=10) were girls with age range from 2 to 6 years. Total 84% patients (n=21) had coin at cricopharyngeus level, while 8% (n=2) at mid esophagus and 8% (n=2) at lower esophagus level. After 24 hours, total of 36% (n=9) patients had spontaneous passage of coin. Among them two patients were with coin at lower esophageal level while two and five patients were with coin at middle esophagus level and at cricopharyngeus level respectively. Among the remaining 16 patients only 20% (n=5) needed to go for esophagoscopy and rest 44% (n=11) had removal of coin by using direct laryngoscopy and Magill forceps. Conclusion: A trial of 24 hours for spontaneous passage of coin irrespective of the site of impaction is recommended. If the coin does not pass spontaneously, then upper esophageal level coins should be attempted with Magill forceps. For Left over cases oesophagoscopy should be done. 
Correlation of Duration of Hepatitis C Infection with Triglycerides and Total Cholesterol
Get PDFObjective: To study the correlation of duration of chronic HCV infection with total cholesterol and triglycerides. Patients & Methods: In this cross-sectional observational study we recruited 37 HCV infected patients who were diagnosed at least 6 months ago. Seven patients were excluded due to hyperglycemia. Patients suffering from metabolic disorders affecting total cholesterol and triglycerides were also excluded. Serum triglycerides, total cholesterol, and plasma glucose were measured by enzymatic method. Data was entered on SPSS version 16. Mean, standard deviation was calculated for numerical data. Pearson correlation was used to find association of duration of HCV with Total Cholesterol and Triglycerides. Results: Mean age of 30 subjects was 39.9±9.5 years, duration of HCV infection was 4.1±3.4 years and mean fasting plasma glucose was 81.7±6.4mg/dl. Total cholesterol and triglycerides were 107±30mg/dl and 72.3±23.5mg/dl respectively. Triglycerides showed a significant correlation with duration of HCV infection (p=0.024) and total cholesterol (p=0.001). Conclusion: There is a significant correlation of triglycerides with duration of HCV infection (p=0.024) and total cholesterol (p=0.001)
Effect of Different Sizes of Intraocular Lens on Early Changes of Posterior Capsular Opacification
Get PDFObjectives: To evaluate the effect of different sizes of Intra Ocular lens (IOL) on frequency of development of early changes of posterior capsular opacification (PCO) Patients and Methods: A descriptive study of 12 months’ duration was conducted in department of ophthalmology, Federal Government Services Hospital Islamabad. A non-probability convenient sample of 100 patients aged 58 to 77 years was divided equally into two groups, A and B. Each group was again divided into A-1, A2 depending on overall lens diameter of 12 mm, 13 mm respectively and B-1, B-2 for optic diameter of 5.25 mm, 6mm respectively. Each subgroup comprised of 25 patients. Planned phacoemulsification was performed on all patients. Follow up with patient’s symptoms, Snellen’s charts and slit lamp examination was done on day 7, 30 days, 6 months and a year after surgery. All the results were entered on patient's Performa. Results: In group A where overall IOL size was used, comprising A1(12 mm) & A2(13 mm), 12% (n=3) of (A1) group developed PCO in 1st 12 months and 16% (n=4) of (A2) group developed PCO in 1st 12 months. In group B where optic size was used, comprising B1 (5.25 mm) & B2 (6mm), 24% (6 patients) of B1 group developed PCO and 16% (4 patients) of B-2 group developed PCO during 1st 12 months. Conclusion: IOL of smaller optic size was associated with higher percentage of early changes of PCO than that of larger optic size. IOL of larger overall size was associated with higher percentage of early changes of PCO than that of smaller overall size. Keyword
Frequency of Hepatitis C and Hepatitis B infection in a Tertiary Care Hospital
Get PDFObjective: To determine the frequency of HCV and HBV in patients referred for screening at Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad. Material and Methods: This retrospective study was conducted at the Pathology Department of Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad over duration of 3 months (from 1st January, 2014 to 31st December 2014). The data was analyzed with, Microsoft Excel 2010. Results: Total of 28319 (17040 + 11279) serum samples were tested by ELISA for HCV antibody and HBV antigen respectively. Among the positive samples, 3427 (12.1%) samples were found positive for HCV antibodies, while 843 (7.5%) were positive for HBV antigen. However, the number of samples testing positive for both HBV and HCV out of the total sample size of 28319 were 143 (0.5%). Conclusion: HCV has a higher seropositivity, being more prevalent in females, effecting mostly patients between the ages of 36 years to 46 years compared to HBV that has a lower seropositivity, effecting mostly females with highest number of samples recorded between the ages of 25 years to 35 years. However, it should be kept in mind that these are patients and not healthy donors/ or population. 
Impact of GnRH Agonists and GnRH Antagonists on Embryo Quality, Endometrial Thickness and Pregnancy Rate in In-vitro Fertilization
Get PDFObjective: To compare the effects of GnRH agonists (long protocol) and GnRH antagonists (short protocol) on embryo quality, endometrial thickness (ET) and pregnancy rate in human in vitro fertilization (IVF). Subjects & Methods: In this quasi experimental study 237 patients underwent short protocol and 175 long protocol of IVF. hCG was administrated when 2 or more follicles reached the size of 18mm. After 34-36 hours’ oocytes were retrieved transvaginally. ET was carried out after 3-5 days under ultrasound guidance. Rising β-hCG concentration confirmed the diagnosis of pregnancy. Results: There was no significant difference in proportion of primary and secondary sub fertility between the two groups. Regarding female age, embryo quality and endometrial thickness no significant difference was found between two groups. Number of attempts, no of oocytes, fertilization & cleavage rate, maturation of oocytes and embryos transferred were significantly associated with both long and short protocols. Conclusion: Ongoing research in assisted reproductive technology has identified some issues which are important from the patient point of view such as ovarian hyper stimulation and safe successful pregnancy. This study shows that pregnancy rate is better with long protocol but that is not statistically significant. More studies should be designed with increase power for suitable comparison of long GnRH agonist protocols with short GnRH antagonist protocols. 
Noninvasive Follicular Thyroid Neoplasms with Papillary Like Nuclear Features (NIFTP) Birth of a New Entity-An Attempt to Prevent Cancer Overdiagnosis
Get PDFThere is a worldwide emphasis on preventing overdiagnosis of disease. Overdiagnosis is defined as the diagnosis of a disease or condition that is unlikely to ever cause harm.1 Overdiagnosis is a huge problem which has serious consequences for the patients as well as health care system. For the patients, these include unnecessary treatment with consequent adverse effects and unnecessary monetary burden, as well as the psychological trauma. For health care system, it causes waste of precious resources and unduly increased work load for the health professionals. Such is the global concern for this problem that since 2013, health professionals from all around the world gather for “Preventing Overdiagnosis” conference, held every year. Cancer overdiagnosis has a much greater potential for harm due to its enormous psychological trauma, arduous treatment protocol, rife with life threatening complications and staggering cost for the patient and healthcare system.
Use of Gastrocnemius Muscle and Musculocutaneous Flaps for Coverage of Soft Tissue Defects in Leg
Get PDFObjective: To share our experience of proximally based gastrocnemius flap use, recipient-site variables, donor-site management, complications, and outcomes. Patients and Methods: This retrospective study was conducted at Pak Italian Modern Burn Center Nishtar Hospital Multan from January 2009 to December 2014. The records of 139 patients were retrieved from the departmental medical record system and the required information regarding the demographic, diagnostic, and clinical data (like patients' particulars---age and sex, history of occupation, any previous surgery , causes of the defects , the extent and dimensions of the defects, time since injury, exposure of bone or tendons, presence of chronic osteomyelitis, , any co-morbid conditions, postoperative course regarding wound-healing difficulties, flap loss, postoperative palsy of the peroneal nerve after elevation of lateral gastrocnemius and walking limitations) were noted. Pre and post-operative photographs and radiographs were also evaluated along with follow up of at least 6 weeks. Results: Out of 139 our 134 flaps survived with only 1 flap having partial necrosis and 4 flaps with marginal necrosis. The complication rate is low Conclusion: GC is a robust flap and is number one choice in proximal tibial defects as even in extensive trauma this flap can be elevated and used safely. 
Role of Nigella sativa in Carbon Tetrachloride induced Hepatotoxicity
Get PDFObjective: To evaluate the protective role of Nigella sativa in carbon tetrachloride induced hepatic changes in rabbits. Material and Methods: This Case control experimental study was conducted at Department of Pharmacology, ISRA University Hyderabad during July 2011 to November 2011. A total of 45 rabbits were divided into three groups consisting of 15 animals in each group A, B and C. Each group was further divided into three sub groups. Sub groups (A1,B1 and C1) received treatment for one week. Sub groups (A2, B2 and C2) received treatment for two weeks. Sub groups (A3, B3 and C3) received treatment for three weeks. The animals in group A (control) received normal saline. The animals in group B were treated with carbon tetrachloride. The animals in group C were treated with carbon tetrachloride and Nigella sativa. Result: In present study sinusoidal congestion, periportal inflammation, kupffer cell hyperplasia, steatosis, necrosis and fibrosis were seen in carbon tetrachloride intoxicated rabbits. These findings were less marked in rabbits treated with Nigella sativa. Conclusion: This study showed the hepatoprotective effects of Nigella sativa in carbon tetrachloride induced hepatotoxicity.