International Journal of Medical Research & Review (IJMRR)
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EGFR scoring in head and neck squamous cell carcinoma and its association with clinicopathological variables
Get PDFBackground: Head and Neck squamous cell carcinoma (HNSCC) is the seventh most common cancer in the world with poor overall survival rate which is unchanged during the last two decades.
Aim: Aim of our study is to measure the level of Epidermal Growth Factor Receptor (EGFR) expression in HNSCC by immunohistochemistry (IHC) and to correlate EGFR with clinicopathological variables.
Settings and Design: Cross sectional study from 1st October 2012 to 31st of March 2014 was performed.
Materials and Methods: After taking detailed history and a thorough examination, biopsy/ specimen of HNSCC region were evaluated to confirm the diagnosis of HNSCC. Paraffin blocks of such tumors were processed for EGFR staining. Staining intensity was evaluated by using scale from 1 to 4.
Statistical Analysis: Chi-square test was used as appropriate for data analysis.
Results: In the present study 38/50 (78%) patients were diagnosed as well differentiated, 12/50(24%) were diagnosed as moderately differentiated. For EGFR staining, 24/50 (48%) scored as +2, 16/50(32%) as +3, 8/50(16%) as +1 and 2/50(4%) scored as 0. 23/38(60.5%) well differentiated SCC cases presented as +2, 5/38(13.2%) as +3, 8/38(21.1%) as +1 and 2/38(5.3%) as 0. 11/12(91.6%) moderately differentiated SCC cases were scored as +3, 1/12(8.3%) as +2. p value 0.001, which is highly significant. However, correlation of EGFR scoring with patients age, sex, addiction history, site of the tumor was insignificant.
Conclusion: EGFR was highly expressed in HNSCC. The result of our study showed that, high EGFR scoring was associated with high grade of the tumor. There was no significant relationship between EGFR scoring and clinicopathological variables
Post-Neonatal tetanus from broomstick injuries: a word of caution for caregivers
Get PDFTetanus is a vaccine-preventable disease that is acquired through exposure to the spores of the bacterium Clostridium tetani which are ubiquitous in the soil. Post-neonatal tetanus is an increasing problem in developing countries, including Nigeria. This is mainly as a result of inadequate immunization coverage, unsustainable immunization programmes, and non-administration of booster doses of tetanus toxoid at appropriate periods to eligible children. The spores of the bacterium can get into the body through broken skin, commonly through injuries from contaminated objects. There have also been reports of broomstick injury as the portal of entry. Indeed, it has been reported to be the commonest portal of entry in a center in Nigeria. This is important because flogging (of children) with brooms is common in parts of Nigeria, despite it being forbidden in several cultures in the country. Two cases of post-neonatal tetanus arising from broomstick injuries in Uyo, Nigeria, are herein reported, to illustrate the inherent dangers and implications of broomstick injuries in children. It is hoped that advocacy campaigns will be conducted at different public health fora to raise awareness of the general population concerning post-neonatal tetanus from broomstick injuries. Furthermore, there is urgent need to institutionalize the administration of booster doses of tetanus toxoid at primary and secondary school entry
Retrospective analysis of HSG in primary infertility
Get PDFIntroduction: Hysterosalpingography used to be a common Radiological Investigation since long time for the investigation of infertility. In the current era of imaging HSG remains to be a choice of investigation for infertility cases. It provides anatomical depiction of uterus and fallopian tubes by introduction of contrast agent.
Objective: Objective of this study is to analyze the common pathological conditions detected on HSG in cases of primary infertility.
Methodology: 140 cases of HSG were reviewed retrospectively in cases of primary infertility. Study covered age ranging from 20 yrs to 42 yrs. The largest number of patients who reported were between the age of 26 – 30 years –47.14 %. Maximum patients were in the marital duration of 2-5 yrs -65%, followed by 6-10 Yrs -24% and remaining 16 % above the duration of more than 10 yrs. Routine use of contraceptives by both partners were excluded in this study. Infertility caused by the male factor was al1so excluded. Standard protocol for HSG was followed with use of water soluble contrast.
Results: Analysis of 140 cases show common cause of infertility as congenital uterine anomalies - 6.42 %, various levels of tubal blocks–17.2%, Uterine SOL/ Fibroid– 4.28% and pelvic adhesions- 6.42%.
Conclusion: Hysterosalpingography still remains the choice of investigation in cases of primary infertility. Most of the cases with primary infertility had a normal HSG, followed by various uterine congenital anomalies and fallopian tube obstruction with or with hydrosalpinx.HSG is repeatable, cost effective, safe and less time-consuming procedure except for the fact that it involves small X-ray exposure to patient
46, XXovotesticular disorder of sex development with serous cystadenomas of the ovary
Get PDFOvotesticular disorder of sex development (DSD) is an extremely rare condition and is defined as presence of both ovarian and testicular tissue in the same individual, regardless of the karyotype and the status of the external or internal genitalia. This disorder was formerly called True hermaphroditism and 400-500 cases have been reported in literature till date. Various chromosomal abnormalities have been described but 46XX is the commonest. Both Mullerian and Wolffian duct derivatives are present in the same individual and the external as well as internal genitalia display a spectrum of phenotypes. The external genitalia are ambiguous and a uterus and a phallus areoften present. The gonads may be ovotestis or a combination of ovary on one side and testes or ovotestis on the other side. These gonads are prone to develop both benign and malignant neoplasms. Tumors like dysgerminoms, seminomas, gonadoblastoma, and mucinous cystadenomas have been described. Serous cystadenomas however, have not been described
Assessment of length of hospital stays of patients with acute exacerbations of chronic obstructive pulmonary disease
Get PDFIntroduction: Chronic Obstructive Pulmonary Disease (COPD) is prone to acute exacerbations which may lead to enhanced morbidity and mortality. Information on the time course and recovery from COPD exacerbation is important in standardizing the length of treatment, in planning appropriate follow up and decreasing loss of working days of the patient.
Material and Methods: It was a prospective study (observational) which included all patients with Acute Exacerbation of COPD (AECOPD) admitted to the Department of Pulmonary Medicine, People’s College of Medical Sciences & RC, Bhopal, over a period of 1 year 6 months.
Results: In this study we observed the mean length of stay (LOS) of patients with AECOPD was 9.53±3.4 days. There was no significant difference in length of stay between patients in different age groups. The LOS varied significantly between different GOLD stages. The patient who had a history of admission for twice or more in the past 1 year had a greater mean LOS as compared to patient with just one or no hospitalisation in the past.
Conclusion: The patient who had a history of admission for twice or more in the past 1 year had a greater mean LOS as compared to patient with just one or no hospitalisation in the past
Survey of Saudi Publications in the Highest Impact Medical Journals
Get PDFObjectives: The four Highest Impact Medical Journals (HIMJs) and their 2015 impact factors (IF)s are: New England Journal of Medicine (55.8), Lancet (45.2), Journal of the American Medical association (35.3) and British Medical Journal (17.5). The purpose of this study is to evaluate publications in HIMJs that originated from the Kingdom of Saudi Arabia (KSA) and to assess the influence of time on their characteristics.
Methods: Using the key word Saudi Arabia an advanced online search was carried out in the web sites of the four HIMJs in August 2015. The inclusion criteria were publications in HIMJs during 1985-2015 in which at least one KSA researcher was included in the authorship. The influence of time on the publications characteristics was assessed by comparing articles published in the recent 4 years with those published in the other 27 years based on a number of parameters and using a chi-squared test.
Results: 30 KSA articles that were published in the HIMJs during 1985-2015. The median IF was 45.2.The annual rates for KSA publication in HIMJs had increased eight folds in the recent 4 years compared to the other 27 years (4/year versus 0.5/year). Furthermore, publications in recent years had significantly more major KSA contribution and more were Middle Eastern Respiratory Syndrome (MERS) -related. However, the journal IF, authors number, first author affiliation, international collaboration, research type and citation numbers were not found to be influenced by the timing of publication.
Conclusions: There has been an encouraging recent upsurge of KSA publications in HIMJs. The increasing ability of KSA researchers to publish articles in HIMJs reflects scientific evolution. However, most of the research of late had been MERS-related. The paucity of pioneering research in other topics and in the undertaking of trials is indicative of shortage of innovative ideas. KSA needs to develop its own elite research minds
Laboratory surveillance of H1N1 swine influenza A virus infection in patients with severe acute respiratory illness (SARI)-an institutional study
Get PDFIntroduction: Lower respiratory tract infections (LRTI) are a leading cause of death in developing countries and are also third leading cause of death worldwide. Influenza is an acute viral and highly contagious respiratory infection causing significant morbidity and mortality. The 2009, swine flu pandemic is caused by a novel reassorted H1N1 subtype of H1N1 influenza A virus.
Objectives: The present laboratory study was conducted for the active surveillance of H1N1 swine influenza A virus infection in type C category of patients with Severe acute respiratory illnesses (SARI).
Materials and Methods: In clinically suspected cases of swine flu, a total of 130 deep nasal / throat swabs were collected and inoculated into viral transport medium (Himedia labs ) and In the reference lab, samples were tested with Real time reverse transcriptase PCR for universal influenza A (inf A), swine influenza A (SWinfA) and swine H1 (SW H1) probes.
Results: Among the total 130 samples, 32 are showing positive by Real time RT-PCR with a prevalence of 24.61%. In 0-5 age group, 10 were positive with prevalence of 62.5%. In total 66 were males with 12 positives (18.18 %), 64 were females with 20 positives (31.25%).
Conclusion: H1N1 influenza A is a potentially infectious disease, which spreads by droplet infection, so laboratory based surveillance is necessary to know the intensity of infection, seasonal trends and epidemiological factors like variations according to gender, age and region; which is also helpful for local health authorities to take the appropriate control measures
A prospective study on association of serum uric acid level with knee osteoarthritis
Get PDFBackground: A numbers of studies have described a relationship among serum uric acid level and generalized osteoarthritis in recent past, but studies on evidence of relationship among serum uric acid and knee joint osteoarthritis are limited. Present study is intended to validate the association between serum uric acid levels and osteoarthritis of kne joint.
Methods: This is a prospective study including three hundred forty patients (225 males, 115 females) with clinically diagnosed osteoarthritis of knee. Patient’s radiographs of affected knees and hands were obtained along with their serum uric acid level, Rheumatoid factor and C reactive protein level. Keligren-Lawrence osteoarthritis scale was used for grading of knee osteoarthritis roentgenographically. On the basis of serum uric acid levels, all the patients were divided in to three groups acoording to serum uric acid level Group 1: - serum uric acid less than 5mg/dl, Group 2: - serum uric acid levels between 5.1-7 mg/dl, Group 3: - serum uric acid levels greater than 7 mg/dl.
Results: Out of 340 patients, 238 patients (70 %) dignosed as isolated knee joint osteoarthritis, generalized osteoarthritis is seen in 66 (19.6 %) patients, and Rheumatoid Factor, along with C-reactive protein is positive in 36(10.5%) patients. Association of osteoarthritis of knee joint, generalized osteoarthritis with the highest tertile of serum uric acid level found to be strongly positive [adjusted odds ratio- 2.31 and adjusted odds ratio- 3.27 respectively). Also association between increasing serum uric acid levels and progression of the osteoarthritis of knee found to be positive.
Conclusion: This study supports a possible correlation between hyperuricemia and osteoarthritis. also a positive association of knee joint osteoarthritis, generalized osteoarthritis progression with increasing uric acid level is suggested
Recurrent rheumaticactivity in rheumatic heart disease
Get PDFIntroduction: Acute rheumatic fever (ARF) is caused by autoimmune effect of group A streptococcal infection (GAS). Cardiac involvement is typically pancarditis. Valvular damage persists after the improvement of acute episode of ARF, the persistent valvular defect and its sequel is called rheumatic heart disease (RHD). People with previous episode of ARF are at increased risk of developing newer episodes of ARF and it increases the severity of valvular damage. Thus RHD gradually worsens in patients with recurrent attacks of ARF. Frequent episodes of ARF can be prevented by secondary prophylaxis.
Methods and Materials: All diagnosed cases of RHD were includedand non RHD patients were excluded from this study. Proper history, detailed physical examination, routine laboratory test, ECG and echocardiography were done in all patients. Recurrent rheumatic activity was diagnosed on the basis of modified Jones criteria’1992 and who criteria of 2004.
Results: Among 100 patients studied, 45 cases were hospitalised because of heart failure due to poor compliance of medications, 38 had acute attack of rheumatic fever, and 17 cases were having lower respiratory tract infection. Thus the incidence of acute rheumatic activity in established RHD was 38%. 50% patients were on penicillin prophylaxis and 10% were on oral tablets of penicillin or azithromycin for secondary prophylaxis. It means 60% of the patient population was on secondary prophylaxis.
Conclusion: Recurrent rheumatic activity is a hidden cause of morbidity and mortality in established cases of RHD as penicillin prophylaxis is not adequate because of poor compliance to the drug
A study on ocular manifestations in patients with Diabetes mellitus
Get PDFBackground: Ocular complications other than Diabetic Retinopathy are frequent among diabetic population. This includes diseases causing reversible and irreversible visual loss.
Aim: The aim of this study is to find out the frequency of occurrence of different ocular manifestation in patients with diabetes mellitus.
Design: Hospital based cross – sectional study on diabetic patients visiting the outpatient department of ophthalmology.
Materials and methods: A total number of 820 patients of non insulin dependent diabetes mellitus (NIDDM) and insulin dependent diabetes mellitus (IDDM) were included in this study. Ocular examination included oblique illumination study and slit lamp examination for all patients. Visual acuity was recorded using Snellen’s chart and intraocular pressure was measured using Gold man aplanation tonometer. A-Scan, fluorescein angiography and field charting using automated perimetry were done in selected cases. The results were recorded in a separate proforma for convenience of analysis.
Results and conclusion: Our study showed cataract as the most common ocular manifestation in patients with diabetes mellitus (DM) followed by diabetic retinopathy. Development of diabetic retinopathy is directly proportional to the duration of the disease. The frequency of occurrence of various manifestations is similar to that of studies conducted worldwide