Journal of Muhammad Medical College ( J Muhammad Med Coll)
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Health Services Performance for TB Treatment in Two Districts of Punjab –DHQ Sahiwal & BVH Bahawalpur.
Full text linkIntroduction: Pakistan ranks 5th among the 22 countries with the highest incidence levels of tuberculosis (TB) smear-positive case; TB remains the leading killer infectious disease in the world, with 1.7 million death.
Objective: The objective of our study is to determine the health services performance for TB treatment in DHQ, Sahiwal and BVH, Bahawalpur with the attributes for treatment.
Methodology: For this cross-sectional study 100 TB patients were identified through simple random sampling. Relevant information was collected by using the Primary Care Assessment Tool adapted for TB care. Data was entered and analyzed by SPSS version 22 and presented as number and percentages.
Results: Results from both cities for male and female patients were recorded with respect to “Access to treatment”, ‘Home visits’, “bond”, “professional respond clearly” and “range of services”. The dimension “coordination’, “family focus”, and “Professional ask about living conditions” were also recorded.
Conclusion: Incentives to improve care organization and management practices can contribute towards a better performance of health services in TB treatment in Pakistan and all over the world.
Keywords: Health services, Performances, TB treatment
Analysis of Helicobacter pylori gastritis according to Sydney classification.
Full text linkIntroduction: Since H. Pylori has been isolated in stomach and duodenum, there were individual methodologies to explain the grading according to colonization and density of microorganism. In 1990 Sydney system of classification was proposed at the 9th world congress of gastroenterology in Sydney Australia, based on topo-graphical, morphological and etiological findings. This classification revised in 1994 and updated by experts in Houston Texas. H. Pylori is major cause of chronic gastri-tis results in gastric and peptic ulcer. It also causes MALT lymphoma and malignan-cy. For histopathological examination four specimens, two from antrum and two from corpus are recommended.Objective: To evaluate the Sydney system of classification and grading for H. Pylori in local population.Methodology: 287 cases of biopsies received at the department of pathology Mu-hammad Medical College, Mirpurkhas Sindh Pakistan, during the period of January 2017 to December 2018 were revised. Sections stained with Hematoxylin and Eosin; Alcian blue and periodic acid Schiff to define H. Pylori and associated pathological changes. The microscopical findings classified according to upgraded Sydney pattern.Results: Out of 287 cases of gastric biopsies 23 (8.0%) were positive for H. Pylori. chronic inflammation present in 168 (58.5%). Neutrophilic activity found in 58 (18.1%). Atrophy without metaplasia observed in 31 (10.8%). Intestinal metaplasia present in 1 (0.3%) cases.Conclusion: Sydney system of grading is best to evaluate chronic gastritis and relia-ble indicator of H. Pylori microorganism.
Keywords: Chronic gastritis, Gastric carcinoma. H. Pylori
Hazard of pesticides on the hearing of farmers.
Full text linkIntroduction: As the population of world is increasing there is increased use of pes-ticides to enhance the crop production. Farmers are trying different types of chemi-cals to kill harmful germs, but they are exposing themselves to different hazards. Throughout the world insecticides are used to kill insects that harm crops. These insecticides are usually neurotoxic. They have a lethal effect on the nervous trans-mission. Peoples who are exposed to these poisons are also at great risk of neuro-toxic effects .Objective: To study the effects of pesticides on the hearing of the farmers. It was a retrospective and descriptive type of study which was conducted in the department of physiology in association with department of ENT.Methodology: This retrospective study done between Mar 2019 to Aug 2019 at ENT department of Liaquat University Hospital Hyderabad. 100 subjects (50 study group having exposure to pesticides for at least five years, while 50 subjects as controls having no history of exposure to pesticides during last 5 years) were selected. The selected participants were subjected to a detailed otoscopic examination and if no other cause e.g. conductive deafness was found, the selection was finalized. The finalized participants were undergone through a comprehensive audiometric evalu-ation.Results: showed pesticide damages the hearing (P= .003). There was no link be-tween the age of farmers and hearing loss (1.00). It was found that as the duration of exposure increased the intensity of hearing loss increased (.001). It was also de-tected that that hearing loss was more frequent in nonprofessional than in profes-sionals (.001).Conclusion: This study revealed that pesticide affects sense of hearing in humans.
Keywords: Pesticide, hearing loss, Farmers
To determine morphology after administration of tetracycline and zinc chloride in adult albino rats and prenatal conceptus.
Full text linkIntroduction: Administration of tetracycline therapy is controversial during growing age as stated by earlier workers. However the effect of simultaneous administration of tetracycline & Zncl2 on pre-natal concepts has remained undocumented.Objective: To compare the effect on conceptus after maternal ingestion of tetracy-cline and Zncl2 by prospective experimental animal study model using adult albino rats.Methodology: Tetracycline & ZnCl2 was administrated to pregnant female albino rats two times therapeutic dose for 10 days. (from day 8 to day 18 of pregnancy.) Each animal was weighted on day 1, day 8 & day 18 of pregnancy. Abortion resulted on day 18th of pregnancy. Each group of pregnant animal were scarified on day 18 of gestation by overdose of either anesthesia, abdomen opened, uterus & both cornu containing conceptus identified, removed, there weight recorded, crown rump length was measured & was compared with similar value of control animals. The results were statistically analyzed to find out the significance.Result: Maternal administration of tetracycline decreased maternal bodyweight to 38.4 ±0.9gm. However simultaneous administration of ZnCl2 maintained body-weights to 41.4 ±0.7gm. The body weight and crown rump length (CR Length) in conceptus decreased by 4.52 ±0.10gm and 3.06 ±0.09 cm respectively. That tetracy-cline & ZnCl2 administration maintained the body weight & CR length by 5.46 ±0.09 gm and 3.79 ±0.13gm respectively.Conclusion: Pre-natal administration of Tetracycline alone cause reduction in ma-ternal body weight as well as reduction in body weight & CR length of rat conceptus. However simultaneous Zncl2 maintain body weight & CR length leading to growth of the rat conceptus.Keywords: Tetracycline, ZnCl2, Rat Conceptus. Crown Rump Length (CR Length)
Evaluating the status of vitamin 25(OH) D levels among females of all age groups in Karachi, Pakistan.
Full text linkIntroduction: Vitamin D plays an important role in growth, metabolism and reproduction. Deficiency of this vitamin is highly prevalent globally and leads to various disorders besides different skeletal deformities. Women of different reproductive ages are at higher risk of developing bone diseases because of low vitamin D levels.
Objective: This study aimed to assess the prevalence of vitamin D deficiencies in females of different ages in Karachi, Pakistan
Methodology: A retrospective investigation of vitamin D levels during a six month period at the Clinical Lab, Al-Khidmat Diagnostic Center, Karachi; Pakistan was performed. Serum vitamin 25(OH) D levels of 1035 female were measured by Electrochemiluminescence (ECL) assay. The data was analyzed through SPSS version 16.
Results: Among 1035 participants of different reproductive ages, 26.1% (n= 270) showed severe vitamin D deficiency, 44.3% (n=458) displayed mild to moderate Vitamin D deficiency while 29.7% (n=307) were having normal levels of serum vitamin D.
Results: The data of 1035 subjects was examined and the mean serum vitamin 25(OH) D levels of the studied subjects were found as 21.04±14.13 with the minimum and maximum range of 4.97ng/ml to 70.71ng/ml
Conclusion: 70.4 % of our studied population had lower levels of vitamin D representing that the majority of Pakistani womenfolk have vitamin D Deficiency.
Keywords: Vitamin 25 (OH) D levels, Female population, Karachi.
 
Knowledge Attitude and Practices of adolescent youth regarding Hepatitis B & C in district Hyderabad
Full text linkIntroduction: Globally Hepatitis B and C is a major public health problem & potential cause of substantial morbidity and mortality. Pakistan has been rated among countries which are endemic for hepatitis B and C where disease burden is high.
Methodology: A cross sectional descriptive study was conducted from June- August 2006 in government colleges of district Hyderabad. 243 students were interviewed by using a pre-tested, closed ended questionnaire. The variables assessed were regarding knowledge, attitude and practice towards hepatitis B & C
Results: 243 students were approached for interviewed. 10% (n=25) knew that hepatitis is caused by virus. 84% (n=205) agreed that it is transmitted from one person to another person. Among these 29% (n=71) agreed on reuse of syringes, 19% (n=47) attributed unscreened blood transfusion, 18% (n=44) consider reuse of blade and sexual intercourse as a mode of transmission. 45% (n=110) mentioned it as preventable disease, in this group 17% (n=42) advocated safe sex practices, 15% (n=37) stated vaccination, 12% (n=30) recommended use of new disposable syringe, 10% (n=25) advocated use of new blade and 8% (n=20) stressed screening of blood before transfusion. 71% (n=173) & 68% (n=166) respondents used new syringe & new blade respectively. 29% (n=71) were vaccinated against Hepatitis B. Television was the leading source of information.
Conclusion: Students’ knowledge regarding Hepatitis is low, but their preventive practices are good. Majority of students were unvaccinated against Hepatitis B. Messages about Hepatitis may be incorporated in media to increase the level of awareness.
Key Words: KAP, Youth, Hepatiti
Incidentally detected asymptomatic HBV positive subjects with slightly raised liver alanine amino transferase (alt).
Full text linkIntroduction: One third of world population (Two billion people) has been infected with hepatitis B virus. It is one of the most common infectious diseases among the world’s leading cause of death. HBV induced chronic liver disease is also an important precursor for the development of hepatocellular carcinoma even in absence of cirrhosis. Many subjects are un aware of viruses that are the cause of hepatitis except when they have been fully involved by the disease and it has become apparent with significant signs and symptoms.
Objective: To discuss raised liver Alanine amino transferase (ALT) activity in asymptomatic HBV positive subjects.
Methodology: This study was carried out at pathology laboratory Muhammad Medical College Mirpurkhas from January 2015 to July 2016. Total125 hepatitis B positive asymptomatic subjects were selected and screened out as routine laboratory investigations.
Results: Selected asymptomatic subjects showed normal Reference levels for TB, ALK and GGT. While ALT was raised above reference range.Conclusion: To give awareness regarding the appropriate measures to reduce the risk in subjects which are asymptomatic and unaware of liver viruses with slightly raised enzyme activity.
Key Words: HBV, ALT, Hepatiti
Comparison of Immunochromatography test (ICT) with real time polymerase chain reaction (RT – PCR) in detection of HCV.
Full text linkObjectives: To compare ICT rapid test with RT- PCR.
Methodology: This study conducted at Pathological Laboratory Muhammad Medical College Hospital during July-August 2016 with collaboration of The Health Foundation District Sanghar at Goth Haji Khair Muhammad Junejo Kandiari Dist: Sanghar Sindh. 400 subjects from whole the population approximately 674 persons of Goth Haji Khair Mohammad Junejo taulka kandiari district Sanghar were selected in between the age of 10 years to 70 years. The purpose was to treat them if they are HCV positive. All the subjects were first screened for Anti – HCV on ICT method, and then all positive cases were confirmed on RT – PCR.
Results: This study conducted during the month of July and August 2016. Total 400 asymptomatic subjects from both male and female were screened by ICT method for Anti – HCV. Out of 400 subjects, 142 (35.5%) were positive. The serum of all 142 subjects positive on ICT, sent to Rawalpindi for HCV qualitative test on RT – PCR, HCV detected in 84 (59.16%) cases and 58 (40.84%) cases were negative. The ratio of variation (ICT: RT-PCR) was 1.44.
Conclusion: Rapid ICT method is less sensitive compare to RT – PCR. There is variation of results in between two methods. All positive cases on ICT must be confirmed on RT – PCR. There is false positivity in ICT method.
Key word: ICT (Immunochromatography test) RT – PCR (Real time polymerase chain reaction) RIA
(Radio immunoassay) ELISA (Enzyme linked immunosorbent assay) EIA (Enzyme immunoassay).  
Prevalence of Pre-Diabetic State among Medical Students of Muhammad Medical College
Full text linkIntroduction: Diabetes is one of the most prevalent disease in Pakistan. Pre-Diabetes is the predisposition to diabetes. This study was conducted to identify the high-risk pre-diabetes individuals and the associated risk factors.
Methodology: A cross section al, descriptive study was conducted among medical students of Muhammad Medical College, Mirpurkhas. Total 100 were identified by using convenience sampling technique, after taking informed consent. WHO recommended procedure Oral Glucose tolerance test were performed and a face to face interview was conducted to collect information to identify associated risk factor by using closed ended pre- tested questionnaire. Data was entered and analyzed by using SPSS version 16.
Result: In total study sample of 100 patients; common age group was 20-22 years (n=49, 49%) and majority were male (n=56, 56%). Family history was present in 64% of study sample. Although all participants were disease free, results of oral glucose tolerance test showed that12% were at pre-diabetic state (FBS>110 &RBS>140). Among these 12 participants, 5(41.7%) were overweight, 4(33.3%) were obese, while 3(25%) were having normal BMI. Among this cohort of prediabetic, 75% have positive family history of diabetes, 50% spend 2-5 hour free with no physical activities, 90.9% take junk food, 91.7% take stress about their family/study and 50% have family history of obesity.
Conclusion: Results of current study showed 12% prevalence of pre-diabetic among medical students. The family history of diabetes, obesity, sedentary lifestyle, stress and use of junk foods are associated risk factors. As a preventive measure, health education should be given to all medical students particularly high-risk group.
Key Words: Pre-diabetic state, Oral glucose tolerance test, Overt Diabetes
Pseudo-neoplastic Lesions of Prostate and the Diagnostic Deception
Full text linkIntroduction: Many pseudo-neoplastic lesions of the prostate gland are recognized. Histologically these lesions mimic the adenocarcinoma of prostate. Pseudo-neoplastic lesions comprise of different glandular and non-glandular or solid patterns. Largely emphasized on the epithelial origin but some stromal and solid lesions are also important. In developing countries, the routine Hematoxylin and eosin (H&E) stain is most commonly used to stain the histological tissue sections. The other stains and molecular studies are not frequently used. The pseudoneoplastic lesions are so obscure and deceptive that sometimes it become very difficult to recognize. The diagnostic facilities both in government and private sector should have at least the facility of immunohistochemical staging to avoid misinterpretations.
Methodology: This retrospective study performed at Muhammad Medical College Mirpurkhas Sindh. 192 specimens of radical prostatectomy (RP) and transurethral resection of the prostate (TURP) received between January 2015 to December 2017 were retrieved for review. All retrieved blocks processed as per standard histopathological techniques. Fresh tissue sections taken and stained with H&E.
Results: All tissue sections reviewed to observe the glandular patterns, their architectural morphology, cytological changes and inflammatory process. The lesions were distinguished on epithelial origin and glandular patterns. Cases of benign prostatic hyperplasia were 169 (88 %), adenosis 06 (3.12 %), reactive hyperplasia 06 (3.12 %), Post atrophic hyperplasia 05 (2.6 %), benign stromal proliferation 02 (1 %) and prostate carcinoma 04 (2%).
Conclusion: Many pseudoneoplastic lesions of the prostate are the mimicker of adenocarcinoma. On H&E stains it sometimes become difficult to differentiate the lesions. The histomorphological diagnosis of these lesions should be facilitated at least by immunohistochemical stains at diagnostic tcenters.t
Keywords: Immunohistochemistry, Transurethral resection of prostate (TURP), Radical prostatectomy (RP). Hematoxylin and Eosin (H&E)