National Journal of Health Sciences
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Effects of Tobacco Chewing and Smoking and Its Relationship with Periodontal Health
No full textAbstract: Tobacco smoking and chewing is a significant contributing factor of periodontal health. Tobacco consumption increases the probability of periodontal disease by affecting the periodontal attachment, pocket formation as well as bone loss. The purpose of this study was to examine the effects of tobacco consumption and its relationship with periodontal health. This is a cross-sectional study of 169 participants chosen from an urban population with an age distribution from 15 to 65 years. Among the study population, 130 were males and 39 were females with the data collected and analyzed by SPSS version 16. The study revealed a significant relationship between the use of tobacco and gingival index, the plaque index, and the community periodontal index of treatment needs. According to the results, there was a high correlation between intake of tobacco and the gingival score
Hodgkin Lymphoma in a Child Presenting as HLH (Haemophagocytic Lymphohistiocytosis)-EBV is Central to Both Entities: A Case Report and Review of Literature
No full textAbstract: HLH is a rare life threatening systemic disease resulting from unregulated immune activation presenting with diverse clinical manifestations and etiologies. While Primary or familial HLH is a relatively common occurrence in infants and young children, secondary HLH due to infections, malignancy, rheumatologic and autoimmune disorders is infrequent and carries a grave prognosis owing to delayed or misdiagnosis. Albeitits rarity in children, EBV infection remains the leading cause of both Hodgkin's lymphoma and HLH worldwide. Additionally, data for simultaneous presence of these three entities at the time of diagnosis is limited. Our report focuses on one such case where a patient's clinical signs and symptoms were non-specific and masked by previous history of idiopathic HLH. After being in remission for 2-3 months patient again relapsed but this time around the etiology was Hodgkin's lymphoma with an underlying EBV infection
How Obesity Affects Our Health
No full textAbstract: Introduction: Obesity is a form in which there is fat collection of body overweight or adipose tissue. This accumulation happens in lean body mass of muscles and unlike connective tissue. Obesity is consummate constantly defined by the body mass index (BMI), a mathematically formula of weight-for-height index. BMI has a high interaction with adiposity and it interacts well with fat weight at the population rank. Obesity is defined as abnormal all excessive accumulation that may be harmful to health. Although, its etiology has been associated with and energy imbalance between calories consumed and calories expended, which is mainly as a result of a poor diet and insufficient physical exercise. Obesity is a worldwide epidemiologic syndrome depict by fat mass accumulation, mainly visceral fat. Obesity cause several diseases like genetic and metabolic issues, urea cycle problems, turner syndrome, Down syndrome, cystic fibrosis and Wilson’s disease etc. Several factors are the cause of obesity like high sugar consumption but by taking some precautionary measures we can be secure from obesity
Fanconi Anemia
No full textAbstract: Fanconi anemia(FA) is the most common inherited bone marrow failure disorder characterized by cytopenias, somatic defects and increased propensity to develop malignancies. Chromosomal breakage analysis is the gold standard diagnostic test for this disease but it may produce false negative results. Therefore, genetic analysis is necessary for confirmation and complement group identification that will help in prenatal diagnosis. Phenotypic presentation of FA is quite variable. 20-30% patients are physically normal. Affected patients may exhibit anamolies of multiple organs or just a few café au lait spots. Therefore diagnosis of this disease remains challenging. Similar to its phenotype the pathophysiology of this disease is also complicated and still not completely understood. The basic defect is in the DNA repair mechanism. The 21 complementation genes responsible for DNA repair are hampered at any one or multiple levels. The chromosomes from the cells of these patients therefore show spontaneous breakages. The incidence of this disease throughout the world is very rare about 1-2/350000 Persons. It is more common in Jews. In Pakistan incidence of FA is still not known and many of the physicians and surgeons don’t have in depth knowledge as they consider it as a rare disease. However, because of the custom of inter marriages its incidence may be surprisingly high. Therefore in depth knowledge of this disease is necessary. The aim of this review article is to provide information to the physicians dealing such patients so that they should be timely diagnosed and managed accordingly
Hb Sallanches: A Rare Mutational Variant of Alpha Thalassemia with Codon 105 Involvement
No full textAbstract: Thalassemia is the most prevalent disease in our part of the world. Due to its mode of inheritance, timely diagnosis and identification can help in eradicating the fatal and life threatening consequences of this disease. With the advent of new molecular and genetic testing, many novel and rare mutations have been diagnosed that have their own clinical implications. We hereby report a case of a 40 year old male with multiple comorbidities and significant family history of sibling death at early age. He was worked up and identified as a case Hb Sallanches which is a rare mutational variant of Alpha thalassemia with codon 105 involvement. This case report highlights the significance of timely diagnosis and identification of this disease in order to limit its fatal consequences on morbidity and mortality. This will assist in improving quality of life of such patients and will also help them to plan and save their future generations from this disease. 
Extreme Thrombocytosis not always Essential Thrombocythemia BCR-ABL has to be Done Timely
No full textAbstract: Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm in which the major proliferative component is comprised of granulocytes and is characterized by translocation of BCR-ABL and formation of Philadelphia (Ph) chromosome. Extreme thrombocytosis in chronic myeloid leukemia is rare and mimic essential thrombocythemia. Thus, chronic myeloid leukemia should be ruled out in patients who present with extreme thromobocytosis. A 28 years old female presented to us with abdominal discomfort, bleeding gums and hematuria. Her past medical history was unremarkable and there wasn’t any family history of bleeding disorder. On examination she had pallor and splenomegaly. Laboratory studies showed thrombocytosis with platelet count of 6420 x 10^9/L , moderate leucocytosis of 22.8 x 10^9/L along with low hemoglobin of 7.9 g/dL. Workup for acquired von willebrand disease was done which showed vWF: Ag 94%, vWF: Ricof 30%, FVIII 75%. Her cyto reduction with hydroxycarbamide 3g/day was started and patient was proceeded for platelet pheresis. On follow up after two sessions of platelet pheresis her platelet count was still high 3104 x 10^9/L. JAK2V617F, MPL, CALR and BCR-ABL mutations were checked and she turned out to be BCR-ABL positive, rest of the mutations were not detected. Bone marrow biopsy findings were consistent with chronic myeloid leukemia in accelerated phase along with marked proliferation of megakaryocytes present in sheets. Anagrelide was administered to control thrombocytosis and nilotinib 800mg/day was started. Although chronic myeloid leukemia can present with thrombocytosis but platelet count exceeding 1000 x 10^9/L is rare. Our patient demonstrated very high count of platelets (6420 x 10^9/L) and relatively unremarkable white cell count. Most of the symptoms she had were due to thrombocytosis rather than leucocytosis as typically seen in chronic myeloid leukemia
Paradigm of Bone Marrow Metastasis in Retinoblastoma
No full textAbstract: Introduction: Retinoblastoma is most common pediatric ocular malignancy. Majority of patients presented with unilateral disease. Infiltration to other organs is common with bone marrow being one of the most common organ involved.Methodology: This study was conducted at Pakistan Institute of Medical Sciences Islamabad for a period of one year. A total of 47 known patients of retinoblastoma were included in study. All patients underwent bone marrow biopsy for evaluation of infiltration. Results: Out of 47 patients, 32 (68.1%) were male and 15 (31.9%) were female (ratio 2.13:1). 37 (78.7%) patients were unilateral and 10 (21.3%) were bilateral. Bone marrow infiltration was present in 14 (29.78%) cases. Conclusion: Bone marrow is among most common sites of involvement in patients with bone marrow biopsy. Distant metastatic involvement has great impact on treatment and overall survival of patients
Prevalence of Intestinal Parasites among Public and Private School Children below 10 years’ at Tarakeswor-10 Manamaiju, Kathmandu, Nepal
No full textAbstract: Introduction: Intestinal parasitosis is one of the chief causes of public health problems particularly in developing countries. Subject and Methods: Among the various health problems amoebiasis and helminthic infection are still significant among the school pupil in context of Nepal. In this article, we reported the status of intestinal parasitosis among the school pupil in this area. Present study was aimed in finding out the prevalence of intestinal parasitosis in public and private school pupil below 10 years at Tarakeswor-10 (Kathmandu Valley). A total of 160 (80 from public and 80 from private school) stool samples collected in clean, dry and screw capped plastic container were studied for the presence of parasites using direct smear method as well as by concentration method. Results: Overall parasite positive rate was 40% (64/160). Positive rate was considerably higher in public school children (47.5%; 38/80) compared with private school (32.5%; 26/80) (P < 0.05). No significant difference in positive rate among boys (53.13% ; 34/64) and girls (46.87%; 30/64) was observed (P > 0.05). However, boys in private school had higher positive rate (boys: 57.69%; girls 42.30%; P < 0.05). Total six genuses of parasites were identified. Of them, Ascaris lumbricoides was most common followed by Trichuris trichiura, Hookworms, Taenia sp., Entamoeba coli and Enterobius vermicularis.Conclusion: Parasites positive rate were higher in children who were drinking untreated water. Children had higher positive rate that were from families without toilet
Prevalence of Lactose Intolerance and its Association with Malnutrition in Children
No full textAbstract: Introduction: Lactose Intolerance is an important indicator of under nutrition, as studied in many setting. More than 60% especially in older school going children had a hypolactasia and half of them had Lactose intolerance. Another dimension of the problem could be lactose intolerance leading to underweight. Objectives: 1. To determine the prevalence of Lactose intolerance in 5-15 years of age group. 2. To determine the peak age group that is most susceptible to lactose intolerance in children of 05 years to 15 years of age. 3. To find out association of lactose intolerance with malnutrition. Methodology: This is a cross sectional study design where a randomly selected 220 children of school going age were provided with lactose drink and their intolerance was assessed by H2 breath test. The child ingests a load of carbohydrate 2 gram/kg maximum 50 gram and the breath is collected in sealed plastic containing and limited interval up 2 hour after ingestion. The hydrogen content of the gas can be easily measured and is reported in particle per min.(ppm) and that’s how malabsorption of any lactose can be evaluated.Results: Results of this study shows 31% percent prevalence in children, who had Lactose intolerance in-group of 220 symptomatic children. In this study the highest number of Lactose Intolerance was found in oldest age group that is more than eleven years and 33% in lowest age group (less than 8 years of age). The numbers of tolerant and intolerant children in normal height group were 73% and 27% respectively. Stunted group had 42% intolerant and 58% tolerant Children. But when tolerant group (Negative HBT) was observed the difference in stunted and normal height group children was statistically significant (p = 0.034). Difference in the number of intolerant children (Positive HBT) in stunted group and normal height group was not statistically significant. 25.9% were underweight, amongst them 37% were intolerant and 63% were tolerant, but on the other hand 74.1% normal weight children, whose weight was above the 80% of median, 28.8% were intolerant and 71.2% were tolerant. This also indicates that underweight children had more intolerance in comparison to normal weight children but this was not statistically significant (p = 0.26). Conclusion: It is possible that nutritional status may affect lactose absorption, so that lactose mal-absorbers may be less well nourished than lactose absorbers. We could not fully link up the lactose intolerance and under-nutrition, but we can recommend on the bases of finding in this research that whenever new policies of combating malnutrition were framed, use of milk in supplementation program should be used with caution
Frequency of UTI in Children Presenting with Fever without Focus
No full textAbstract: Objective: To determine the frequency of Urinary tract infections in children presenting with fever without a focus – a tertiary care hospital experience. Material and Methods: It is a descriptive cross sectional study to find out the frequency of UTI conducted from 26th April to 25th October 2013. Patients of either gender, 1 month to 36 months of age, presenting with the complaints of fever without focus were included. History and physical examination were done; urine sample was collected for analysis and culture. Data was recorded on a pre designed Proforma. Mean and standard deviation for quantitative, frequencies and percentages for qualitative variables were computed. Stratification was done to observe the effects of modifiers on outcome. Post stratification chi square test was applied and p value ? 0.05 was considered as significant. Results: Among total 126 study subjects 62 patients were male. The mean age was 13.96 ± 8.56 months. Mean age of patients was 13.88 ± 6.50 months and 13.97 ± 8.86 months for patients with and without UTI respectively. Among patients with urinary tract infection, 9(52.9%) were male and 8(47.1%) were female patients. Age of 9(52.9%) patients was ?13 months and age of 8(47.1%) patients was >13 months. Therewas no significant association of UTI observed with gender (p = 0.741) and age (p = 0.794). Conclusion: UTI is a common infection that can be easily missed in young children. Screening patients at risk can lead to proper diagnosis and a reduction in morbidity