Volume 2 Issue-1 Jan-Mar,13

Cancer of the oral cavity in Pakistan is among the highest in the world which is attributed to the local custom of chewing tobacco products such as paan, gutka and naswar. These things are widely used in Pakistan mainly by the lower socioeconomic group. They pose a high risk for oral cancer. The continuous exposure to corrosive condiments causes abrasions of oral mucosal surface making it more susceptible for virulent strains to gain entry into the basal cells…

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Background:

Human Papilloma Virus (HPV) is found in the oral tobacco chewers with precancerous lesions such as submucous fibrosis (SMF), leukoplakia and erythroplakia. Trismus is a common symptom seen in patients with SMF and oral cancers. In Pakistan the risk of oral cancers has been raised up to 8.5 to 10 times due to increase in tobacco chewers in the recent years.

Objective:

To determine the frequency of oral HPV infection in chewable tobacco users with trismus living in the lowincome areas of Karachi.

Methods:

Camps were set up in 5 different areas of Karachi. In each camp, 100 people were examined for oral lesions by experienced volunteers. Oral rinse (40ml) was taken after gentle brushing over the lesions. DNA was extracted and PCR was performed using Gp5+/Gp6+ consensus primers. The results were analyzed on SPSS version 17.0.

Results:

Out of 187 subjects with trismus, 157 (84%) were males and 30 (15.51%) were females with average age of 28.7 years (12 -70 years). Gutka, Naswar, Chalia and Paan users were 45.45%, 37.56%, 12.83% and 6.95% respectively. Mild trismus was found in 113 (60.43%) subjects followed by moderate trismus in 52 (27.81%) and severe trismus in 22(11.76%). Out of total 36 (19%) HPV positive subjects, 27(14.44%), 7(3.74%) and 2(1.07%) had mild, moderate and severe trismus respectively. 150 controls tested negative for HPV.

Conclusion:

The frequency of HPV in oral cavity was high in subjects with trismus suggesting risk of oral squamous cell carcinoma. HPV in subjects with moderate to severe trismus should be tested in blood because it is difficult to get suitable oral sample.

Key Words:

Trismus, Human Papilloma Virus, Submucous Fibrosis (SMF), Chewable Tobacco.

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Background:

The objective of this study was to measure the pulmonary function tests in various ethnic groups living in Karachi.

Objective:

Five hundred and four subjects were included in this study. All subjects were asked to perform spirometry according to the American Thoracic Society guidelines. All the subjects were divided in to six groups according to there mother tongue like Balochi, Punjabi, Pashtu, Sindhi and Urdu speaking sixth groups comprises of Memons, Gujrati, Saraiki and Hazara people.

Results:

The result of various ethnic groups shows that Punjabis and Pathans have significantly higher values of pulmonary function tests as compare to others.

Conclusion:

Pulmonary function test were higher in Punjabi and Pashtu speaking people because of their genetic and environmental association and their height.

Key Words:

PFT, Spirometry, Genetic, Environmental.

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Background:

During the whole period of pregnancy women’s body undergoes various physical and physiological changes. Due to the change during and after pregnancy common problems faced by the women’s are low back pain, stress urinary incontinence, pelvic pain. Physiotherapy can help in this through postural reeducation, strengthening of pelvic floor muscles and through some modalities.

Objective:

To assess the awareness of obstetricians/ gynecologist regarding the role of physiotherapy in managing obstetric patients.

Methods:

A cross-sectional study was done among gynecologists and obstetricians selected from tertiary care hospitals of Karachi through non-probability convenient sampling, total sample size of the study was 300. Data was entered and analyzed by using SPSS version 17. Chi square test was used to find association for qualitative variables and p value <0.05 was considered as significant.

Results:

From the sample size (n=300) including gynecologists/obstetricians 123(41%) were from government hospitals and 177(59%) from private settings, 156(52%) had 3 to 5 years of experience while 144(48%) had more than 5 years of experience. Regarding referral during antenatal and postnatal period, it was found that 41(13.7%) participants advised most of the time, 203(67.7%) occasionally and 56(18.7%) never advised their patients.
Out of total, 194(64.7%) had an awareness about pre-natal physiotherapy exercises sessions but only 56(18.7%) refer their patients for the antenatal classes (p-value 0.001). From total 204(68.0%) answered yes regarding the role of postnatal exercise sessions but out of them only 60(20.0%) refer for the post-natal physiotherapy sessions regularly and 74(24.7%) occasionally (p-value=0.218).

Conclusion:

Obstetrician/ Gynecologists had awareness about the role of physiotherapy in management of their obstetric patients but only a small portion of them concern and refer their patients for physiotherapy.

Key Words:

Awareness, Obstetricians/Gynecologists, physiotherapy, Obstetric patients

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Background:

News viewing is directly linked to a person’s cognitive behavior and hence deeply affects psychological status of the viewer. Live events and deteriorating images affects different aspects of a person’s cognition. Stress is one of them which was measured in this study using a Psychological Stress Scale (PSS).

Objective:

To assess the psychological effects of viewing news channels among adult population of Karachi, Pakistan.

Methods:

This Cross Sectional study was carried out for a 2 month duration targeting the adult population of Karachi. Total 400 participants were selected through the convenience sampling technique. A pretested and self administered questionnaire was used to collect data. PSS (Psychological Stress Scale) was used to measure stress among study participants. The data was analyzed using SPSS version 20.

Results:

Of total n=400 participants, 273 (68.3%) used TV as the source of getting news and at the time of watching TV 166 (41.5%) preferred to watch news channels. 115 (28.8%) individuals had lasting effect after watching news of violence and 173 (43.3%) participants were stressed after watching news. Using PSS, 288 (72%) individuals had moderate stress score, 78 (19.8%) had low and 34(8.3%) had high stress score.

Conclusion:

It was concluded from the research that news is adversely affecting the psychological health

Key Words:

Psychological Effects, News Channel, Psychological Stress Scale (PSS).

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Background:

The learning methods in health sectors are now facing a great challenge. The study is conducted to determine the effectiveness of new learning methodologies including workshops, seminars and symposiums on the building of students’ professional skills.

Methodology:

A simple questionnaire comprised of closed ended questions was given to four hundred students of different medical universities focusing basic health sciences departments like medical, dentistry and pharmacy.

Findings:

It was found that medical universities were arranging all above mentioned programs on regular basis and students were used to participate in such engagements. Majority of students (52.4%) were in favor of workshops, they thought workshop as the most beneficial technique to improve their weaknesses. While the likeness to seminars and symposiums were nearly on equal basis. Students were strongly agreed (66.2%) that these ways provide current knowledge of the profession than typical teacher centered lectures.

Conclusion:

Therefore, it is concluded that all professional universities should organize maximum of such advanced activities to produce students with better professional attitudes.

Key Words:

Advanced Teaching Methodology, Workshops, Seminars, Symposiums, Educational System.

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Ganglioneuroma is a rare, benign, slow-growing asymptomatic tumor of the neural crest cells. It occurs in one per million population with female predominance. It most commonly occurs in the retro=peritoneum. Although CT scan and other imaging modalities can be used, its diagnosis is essentially based on histopathology. We report a case of 18 year old male who presented with abdominal pain and a mass in the left lumbar quadrant. CT scan abdomen showed a retroperitoneal mass encasing aorta, IVC and left common iliac artery. A diagnosis of Ganglioneuroma was established on ultrasound guided Trucut biopsy. He underwent laparotomy for total excision of mass. Per-operatively the mass was separated from the vital structures and the major blood vessels. His post-operative course was uneventful and he was discharged on 7th post-operative day. His final histopathology confirmed the initial diagnosis of ganglioneuroma. Nonetheless, a possibility of ganglioneuroma should be kept under consideration in cases of all retroperitoneal extra-adrenal masses.

Key Words:

Ganglioneuroma, Retroperitoneal Mass, Extra-Adrenal Mass.

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Misoprostol is a synthetic prostaglandin E1 analogue, commonly used for the medical termination of pregnancy in the first trimester. We present a case of a 29-year-old woman who was admitted due to misoprostol overdose, for a self induced abortion followed by a second overdose for a suicidal attempt. Manifestations of toxicity included agitation, high-grade fever, abdominal pain, diarrhea and minimal pervaginal bleeding. She was managed by a multidisciplinary team involving Medical, Psychiatric and Gynaecological doctors. Treatment was supportive and included gastric lavage, administration of intravenous fluids, anti-pyretics and analgesics. The pregnancy and fetal viability was followed on serial βhCG levels and ultrasound scan respectively, and required surgical management of miscarriage. Patient was discharged in satisfactory physical condition.

Key Words:

Misoprostol, Overdose, Self-induced Abortion, Suicidal Attempt.

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Oral health disparities have exacerbated since the popularity of chewable tobacco among the general population in Pakistan. Karachi South ranks second in the incidence of oral cancer and this frequency is steadily rising. Several molecular studies have shown a link between the use of chewable tobacco products and oral submucosal fibrosis. Oropharyngeal cancer, is being driven by HPV is now well known around the world. Studies in Pakistan on squamous cell carcinoma and precancerous oral lesions, found a high prevalence of Human Papillomavirus (HPV) in patients with male sex showing significant correlation with HPV infection. This paper highlights the causes and risks of the oral epidemic that is threatening our society.

Key Words:

Oral Cancer, Human Papilloma, Smokeless Tobacco

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Helicobacter pylori infection is recognized as a worldwide problem causing gastric diseases. A comprehensive understanding of epidemiological trivia of H. pylori infection is very important in solving the patho-physiological enigma, better management and prognosis of infection. This review focuses on the literature regarding the epidemiology and public health implications targeting H.pylori in drinking water. Drinking water sources both of surface and groundwater are contaminated with coliforms due to human activities like improper disposal of municipal and industrial effluents. These factors also violate the WHO water quality parameters. Prevalence rates vary widely between different geographical regions and socioeconomic strata of Pakistan.

Key Words:

Helicobacter Pylori, Epidemiology, Prevalence, Transmission, Cag A, Vac A.

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