Influence of agro-wastes derived biochar and their composite on reducing the mobility of toxic heavy metals and their bioavailability in industrial contaminated soils.

The agro-waste derived valuable products are prime interest for effective management of toxic heavy metals (THMs). The present study investigated the efficacy of biochars (BCs) on immobilization of THMs (Cr, Zn, Pb, Cu, Ni and Cd), bioaccumulation and health risk. Agro-wastes derived BCs including wheat straw biochar (WSB), orange peel biochar (OPB), rice husk biochar (RHB) and their composite biochar (CB) were applied in industrial contaminated soil (ICS) at 1% and 3% amendments rates. All the BCs significantly decreased the bioavailable THMs and significantly (p < 0.001) reduced bioaccumulation at 3% application with highest efficiency for CB followed by OPB, WSB and RHB as compared to control treatment. The bioaccumulation factor (BAF), concentration index (CI) and ecological risk were decreased with all BCs. The hazard quotient (HQ) and hazard index (HI) of all THMs were <1, except Cd, while carcer risk (CR) and total cancer risk index (TCRI) were decreased through all BCs. The overall results depicted that CB at 3% application rate showed higher efficacy to reduce significantly (p < 0.001) the THMs uptake and reduced health risk. Hence, the present study suggests that the composite of BCs prepared from agro-wastes is eco-friendly amendment to reduce THMs in ICS and minimize its subsequent uptake in vegetables.

The present study has a scientific research scope, based on reduction of bioavailability and bioaccumulation of toxic heavy metals (THMs) by the addition of biochars derived from agro-wastes and their composite biochar (CB), thereby decreasing the potential health risk. Limited study has been conducted, especially on the impact of CB in THMs-contaminated soil. This study could fill the scientific research gap and provides useful information for mitigation of THMs present in contaminated soil, which could be followed by the Environmental Protection Agency, Ministry of Agriculture and farmers in degraded lands.

Peganum harmala L. extract-based Gold (Au) and Silver (Ag) nanoparticles (NPs): Green synthesis, characterization, and assessment of antibacterial and antifungal properties.

During the last decade, nanotechnology has attained a significant place among the scientific community for the biosynthesis of plant-based nanoparticles owing to its effective, safe, and eco-friendly nature. Hence, keeping in view the significance of nanotechnology, the current study was conducted to develop, characterize (UV-visible spectroscopy, scanning electron microscopy, Fourier-transform infrared spectroscopy, and energy-dispersive X-ray spectroscopy), and assess the antimicrobial (antibacterial and antifungal) properties of Peganum harmala L. Extract-based Gold (Au) and Silver (Ag) nanoparticles (NPs). Characteristic absorption peaks at 420 and 540 nm revealed the formation of AgNPs and AuNPs, respectively. SEM images revealed that both silver and gold nanoparticles were oval and spherical with average size ranging from 42 to 72 and 12.6 to 35.7 nm, respectively. Similarly, FT-IR spectra revealed that the functional groups such as hydroxyl, carboxyl, and polyphenolic groups of biomolecules present in the extract are possibly responsible for reducing metallic ions and the formation of nanoparticles. Likewise, the EDX analysis confirmed the presence of silver and gold in synthesized NPs. Furthermore, the AgNPs and AuNPs showed good antibacterial and antifungal activities. The maximum antibacterial and antifungal activity was noticed for P. harmala extract against Pseudomonas aeroginosa (21 mm) and Candida albicon (18 mm), respectively. Whereas, the maximum antibacterial and antifungal activities of synthesized AgNPs were observed against Salmonella typhi (25 mm) and Penicillium notatum (36 mm), respectively. Moreover, in the case of AuNPs, the highest antibacterial and antifungal activity of synthesized AuNPs was noticed against Escherichia coli (25 mm) and C. albicon (31 mm), respectively. Findings of this study revealed that P. harmala extract and biosynthesized NPs (silver and gold) possessed significant antibacterial and antifungal properties against different bacterial (Bacillus subtilis, Staphylococcus aureus, E. coli, P. aeroginosa, and S. typhi) and fungal (C. albicans, Aspergillus Niger, and P. notatum) strains. Further studies must be carried out to assess the probable mechanism of action associated with these antimicrobial properties.

Quantification and characterization of microplastics (MPs) pollution in peri-uburban agricultural lands of Lahore, Pakistan.

Microplastics (MPs) contaminate every conceivable terrestrial and aquatic environment including high peaks and deep marine trenches. Agricultural lands alone are expected to receive plastic up to 23 times more than ocean basins. In this study, soil samples were collected from peri-urban agricultural lands of Lahore on four sides including Kala Shah Kaku (KSK), Punjab University (PU), Dera Gujran (DG), and Sagian (SG). National Oceanic and Atmospheric Administration (NOAA) protocol was used for MPs extraction and analysis. Extracted MPs were analyzed under microscope at 40X magnification and their composition was analyzed using Fourier Transform Infrared (FTIR) spectroscopy. A considerable concentration of MPs was recorded at all sites. The highest contamination was found at SG with 876 ±194 MPs/kg of soil, and the lowest contamination was recorded at PU with 672 ±235 MPs/kg of soil. However, these differences among the sites were not statistically significant (p = 0.29). The overall predominant shape of MPs was fibers (613±71, 79.73%) followed by sheets (125±55, 16.28%), fragments (30±5, 3.9%) and foam particles (1±2, .09%). The differences in the distribution of MPs in various types were statistically significant (p = 0), while differences between sites were insignificant (p = 0.13). About 95% of MPs were less than 2 mm and 85% were less than 1 mm size. The distribution of MPs in various sizes (p = 0) and differences of this distribution between sites (p = 0.037) were both statistically significant. A good diversity of nine colored MPs was recorded, however majority of the MPs were transparent (89.57%). Six polymer including Polyethylene (PE), Polyethylene terephthalate (PET), Polypropylene (PP), Polystyrene (PS), Polycarbonate (PC), and Polyvinyl Chloride (PVC) were identified by FTIR. The current levels of MPs pollution are higher than in many other parts of the world. Composition of MPs (types, colors, sizes, and polymer types) indicates the diversity of their sources and their possible implications on agricultural ecosystem.

Comparison of Postoperative Complications of Open Versus Laparoscopic Cholecystectomy According to the Modified Clavien-Dindo Classification System.

BACKGROUND: Though laparoscopic cholecystectomy has become a gold standard management technique for gallbladder diseases, an open approach can also be used for patients having complicated gallbladder disease. Post-cholecystectomy complications are well-documented in existing English scientific literature but are not well understood according to the grade of intervention required to treat those complications. OBJECTIVE: To compare the postoperative complications of laparoscopic versus open cholecystectomy according to the modified Clavien-Dindo classification (MCDC) system. MATERIALS AND METHODS:  A retrospective study was conducted at the Department of General Surgery, Unit - III, Lahore General Hospital, Lahore, comprising the data of patients operated between July 01, 2021, and December 31, 2021, after departmental approval # SU-III/73/LGH, dated April 1, 2022. Patients with the definitive diagnosis of acute cholecystitis, chronic cholecystitis, cholelithiasis, and cholecysto-duodenal fistula were included, while cases of choledocholithiasis and, gall bladder carcinoma were excluded from this study. Eighty patients met the inclusion criteria, with 40 patients in each group of open and laparoscopic cholecystectomy. Information for the data set of age, gender, history of surgical procedure, immediate and late outcome, length of surgery, and MCDC grade were collected. Low-grade complications were Grade I and Grade II, while Grades III to V were high-grade. RESULTS: The mean age of included patients was 42.52 ± 8.76 and 40.025 ± 8.12 years, in the open and laparoscopic group, with 80% and 90% female preponderance, respectively. Grade I and Grade II complications occurred in both groups of patients, with Grade III only in patients who underwent open cholecystectomy. None of the patients from each group developed Grade IV or Grade V complications. Among 40 patients who underwent laparoscopic cholecystectomy, 35% of the patients developed low-grade complications, whereas 40% of the patients developed low-grade complications after open cholecystectomy, with respiratory complications being the most common. High-grade complications after open cholecystectomy were found among 2.5% of patients, whereas no patients developed high-grade complications following the laparoscopic approach. CONCLUSION: Patients who underwent laparoscopic cholecystectomy are less prone to develop complications than patients undergoing open cholecystectomy, hence requiring low-grade interventions of surgical and non-surgical types. MCDC is a valuable tool for assessing surgical complications and can help improve patient outcomes by providing a standardized method for reporting and comparing complication rates.

Intervene to Improve: Awareness of Testicular Self-Examination and Testicular Cancer Among Male Patients at a Tertiary Care Hospital in Lahore, Pakistan.

Background and objective Testicular cancer is the commonest of all types of cancer males are affected with. Testicular cancer, when diagnosed early, has one of the best prognoses. However, in Pakistan, early detection is hindered by religious and sociocultural norms, lack of education, and awareness deficit. Testicular self-examination (TSE) can significantly facilitate early detection of the condition and decrease associated mortality rate. This study aimed to acquire the frame of mind regarding testicular cancer (TC) and testicular self-examination (TSE) among the male outdoor patients of Lahore General Hospital, Lahore. Materials and methods After ethical considerations, elaborated literature review and consequent pilot study were done to develop a bilingual questionnaire. Following patient consent, answers to a set of questions were noted down by the authors. A 90-second bilingual, motivational video was displayed and an educational pamphlet on the same topic was also handed over. Afterward, another survey was conducted to grasp the comprehension, satisfaction, and willingness to spread the message. Results About 92% of the subjects had not heard of or performed TSE and 58.3% mentioned lack of education as the reason for not knowing the method. Eighty-two percent patients had never heard of TC. Post-education, 100% patients claimed that their knowledge of the subject improved and 97% were ready to teach other male relatives. Conclusion The results indicate that the population's lack of awareness regarding testicular self-examination and testicular cancer is alarming. Most subjects did not know the age group, risk factors, presentation, and early prevention of testicular cancer.

Health risk implications of iron in wastewater soil-food crops grown in the vicinity of peri urban areas of the District Sargodha.

Irrigation using sewage water can be beneficial, as it can increase the productivity of crops but has negative consequences on crops, soil contamination, and human health. It contains a variety of toxins, such as chemicals and heavy metals, which damage the soil and crops. In this regard, the aim of the research was to assess the potential health hazards of iron (Fe) metal in food crops (leafy and root crops) treated with wastewater (T_1), canal water (T_2), and tube well water (T_3). Water, soil, and edible components of food crops were collected at random from three distinct locations. Fe concentration in samples was estimated using atomic absorption spectrophotometer, following wet digestion method. The Fe concentrations, ranged from 0.408 to 1.03 mg/l in water, 31.55 to 187.47 mgkg-1 in soil and 4.09 to 32.583 mgkg-1 in crop samples; which were within permissible limits of the World Health Organization (WHO). There was a positive correlation between soils and crops. The bioconcentration factor, enrichment factor (EF), daily intake of metals (DIM), health risk index (HRI), and target hazard quotient (THQ) all values were <1, except for a pollution load index >1, which indicated soil contamination, but there was no Fe toxicity in crops, no health risk, and no-carcinogenic risk for these food crops in humans. To prevent the excessive accumulation of Fe metal in the food chain, regular monitoring is needed.

Microbial pollution in inland recreational freshwaters of Quetta, Pakistan: an initial report.

Parasitic contamination of surface waters, especially recreational waters, is a serious problem for under-developed nations like Pakistan, where numerous outbreaks of parasitic diseases are reported each year. In the current study, parasitic presence in two surface waters (Hanna Lake and Wali-Tangi Dam) of Quetta was monitored quarterly for 1 year. The methodology involved the pre-concentration of the water samples and the subsequent preparation for the microscopic search of parasites. Physico-chemical and bacteriological variables were also studied. Wet staining, modified Trichrome staining, and modified acid-fast staining methods were used to identify various parasitic forms (cysts, oocysts, eggs, trophozoites). Collectively 11 parasitic elements (10 in Lake and 8 in Dam) belonging to 10 species were recorded, many of which are potential human pathogens. The species identified include Trichomonas sp., Isospora sp., Balantidium coli, Cryptosporidium sp., Entamoeba spp., amoebas, Microsporidium sp., Endolimax nana, Ascaris lumbricoides, and Giardia spp. Parasitic contamination remained persistent in both locations throughout the year independent of physico-chemical parameters (temperature, EC, pH, turbidity, and DO) and bacterial concentration of water. Reliance on bacterial presence for monitoring of recreational waters can be a risk for tourists. Entamoeba spp. and A. lumbricoides may be used for surface water monitoring in these waters.

Combating iron and zinc malnutrition through mineral biofortification in maize through plant growth promoting Bacillus and Paenibacillus species.

Introduction: The burgeoning population of the world is causing food insecurity not only by less food availability but also by the malnutrition of essential nutrients and vitamins. Malnutrition is mostly linked with food having micronutrients lower than the optimal concentration of that specific food commodity and becoming an emerging challenge over the globe. Microbial biofortification in agriculture ensures nutritional security through microbial nitrogen fixation, and improved phosphate and zinc solubilization, which increase the uptake of these nutrients. The present study evaluates the novel plant growth-promoting rhizobacteria (PGPR) to biofortify maize gain. Methods: For this purpose, a pot and two field experiments for maize were conducted. PGPRs were applied alone and in combination for a better understanding of the biofortification potential of these strains. At physiological maturity, the growth parameters, and at harvest, the yield, microbial population, and nutritional status of maize were determined. Results and discussion: Results revealed that the consortium (ZM27+ZM63+S10) has caused the maximum increase in growth under pot studies like plant height (31%), shoot fresh weight (28%), shoot dry weight (27%), root fresh (33%) and dry weights (29%), and microbial count (21%) in the maize rhizosphere. The mineral analysis of the pot trial also revealed that consortium of ZM27+ZM63+S10 has caused 28, 16, 20, 11 and 11% increases in P, N, K, Fe, and Zn contents in maize, respectively, as compared to un-inoculated treatment in pot studies. A similar trend of results was also observed in both field trials as the consortium of ZM27+ZM63+S10 caused the maximum increase in not only growth and biological properties but also caused maximum biofortification of mineral nutrients in maize grains. The grain yield and 1000-grain weight were also found significantly higher 17 and 12%, respectively, under consortium application as compared to control. So, it can be concluded from these significant results obtained from the PGPR consortium application that microbial inoculants play a significant role in enhancing the growth, yield, and quality of the maize. However, the extensive evaluation of the consortium may help in the formulation of a biofertilizer for sustainable production and biofortification of maize to cope with nutritional security.

Elucidating the distinct interactive impact of cadmium and nickel on growth, photosynthesis, metal-homeostasis, and yield responses of mung bean (Vigna radiata L.) varieties.

Contamination of soils with heavy metals (HMs) caused serious problems because plants tend to absorb HMs from the soil. In view of HM hazards to plants as well as agro-ecosystems, we executed this study to assess metal toxicity to mung bean (Vigna radiata) plants cultivated in soil with six treatment levels of cadmium (Cd) and nickel (Ni) and to find metal tolerant variety, i.e., M-93 (V1) and M-1(V2) with multifarious plant biochemical and physiological attributes. Increasing doses of Cd and Ni inhibited plant growth and photosynthesis and both varieties showed highly significant differences in the morpho-physiological attributes. V2 showed sensitivity to Cd and Ni treatments alone or in combination. Tolerance indices for attributes presented a declined growth of Vigna plants under HM stress accompanied by highly significant suppression in gas exchange characteristics. Of single element applications, the adverse effects on mung bean were more pronounced in Cd treatments. V1 showed much reduction in photosynthesis attributes except sub-stomatal CO2 concentration in all treatments compared to V2. The yield attributes, i.e., seed yield/plant and 100-seed weight, were progressively reduced in T5 for both varieties. In combination, we have observed increased mobility of Cd and Ni in both varieties. The results showed that water use efficiency (WUE) generally increased in all the treatments for both varieties compared to control. V2 exhibited less soluble sugars and free amino acids compared to V1 in all the treatments. Similarly, we recorded an enhanced total free amino acid contents in both varieties among all the metal treatments against control plants. We conclude that combinatorial treatment proved much lethal for Vigna plants, but V1 performed better than V2 in counteracting the adverse effects of Cd and Ni.

SCIA: A Novel Gene Set Analysis Applicable to Data With Different Characteristics.

Gene set analysis is commonly used in functional enrichment and molecular pathway analyses. Most of the present methods are based on the competitive testing methods which assume each gene is independent of the others. However, the false discovery rates of competitive methods are amplified when they are applied to datasets with high inter-gene correlations. The self-contained testing methods could solve this problem, but there are other restrictions on data characteristics. Therefore, a statistically rigorous testing method applicable to different datasets with various complex characteristics is needed to obtain unbiased and comparable results. We propose a self-contained and competitive incorporated analysis (SCIA) to alleviate the bias caused by the limited application scope of existing gene set analysis methods. This is accomplished through a novel permutation strategy using a priori biological networks to selectively permute gene labels with different probabilities. In simulation studies, SCIA was compared with four representative analysis methods (GSEA, CAMERA, ROAST, and NES), and produced the best performance in both false discovery rate and sensitivity under most conditions with different parameter settings. Further, the KEGG pathway analysis on two real datasets of lung cancer showed that the results found by SCIA in both of the two datasets are much more than that of GSEA and most of them could be supported by literature. Overall, SCIA promisingly offers researchers more reliable and comparable results with different datasets.

Laparoscopic IPOM repair of an acquired abdominal intercostal hernia.

Acquired abdominal intercostal hernia (AAIH) is an infrequent occurrence whereby intra-abdominal contents herniate into intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. These hernias are difficult to diagnose and should always be suspected when a chest wall swelling occur after major or minor trauma. Surgical repair is warranted in symptomatic patients. The majority of AAIHs are repaired through an open approach using tension-free mesh, with significant recurrence risk. Recently, laparoscopic and robot-assisted repairs have been proposed. We discuss a 49-year-old man presented through outpatient setting with a 5-year history of ongoing left subcostal discomfort and a reducible lump. His history included a workplace accident 5 years ago. Contrast-enhanced abdominal CT confirmed AAIH with omentum herniation into the sac. A successful laparoscopic repair with intraperitoneal onlay mesh technique using composite mesh was performed.

Farmer field school's training on knowledge level of citrus growers regarding improved production practices / Impacto do treinamento da escola de campo para agricultores quanto ao nível de conhecimento dos produtores de citros em relação às melhores práticas de produção

ABSTRACT: The major objective of this paper was to assess the impact of the Farmer field school (FFS) training program on the knowledge level of farmers (citrus growers) regarding improved citrus production practices. Distract Sargodha was the targeted research area for this study being the leading producer of citrus in Pakistan. Quantitative data were collected through interview schedule and analyzed through Statistical Package for Social Sciences (SPSS). It was conclude that young people were more tend towards getting training under FFS program than old age farmers. Educated farmers were in majority in FFS farmers while; conversely illiterate farmers were in majority in the category of non-FFs farmers. In category of FFS farmers livestock farming was their primary income as reported by majority (31.3%) of FFS farmers and in the case of non-FFS farmer's crop sale was their primary income source as reported by 28.4% of non-FFs farmers. In addition to that both FFS and non-FFS farmers also earn income from nonfarm sources like business, job, foreign remittances and labour. FFS training program had positive and significant impact on the knowledge level of farmers regarding citrus production and protection practices. T-test statistics showed highly significant (P<0.05) difference in knowledge level of FFS farmers and non-FFS farmers.

RESUMO: O objetivo principal deste trabalho foi avaliar o impacto do programa de treinamento da escola de campo para agricultores (FFS) quanto ao nível de conhecimento dos agricultores (produtores de citros) em relação às melhores práticas de produção de citros. O Distrito de Sargodha foi a área de pesquisa escolhida para este estudo por ser o principal produtor de citros no Paquistão. Os dados quantitativos foram coletados por meio de entrevistas e analisados por meio do Statistical Package for Social Sciences (SPSS). Conclui-se que os jovens eram mais tendenciosos à obtenção de treinamento através do programa FFS do que os agricultores mais velhos. Os agricultores escolarizados estavam, em sua maioria, na categoria de agricultores FFS, enquanto que os agricultores analfabetos estavam, na categoria de não FF. Na categoria de FFS, a pecuária se mostrou o principal rendimento, conforme relatado pela maioria dos agricultores (31,3%), enquanto que, em 28% dos agricultores não-FFs, a principal fonte de renda era a venda de suas colheitas. Além disso, tanto os agricultores FFS como não FFS também ganham renda com fontes não agrícolas. O programa de treinamento FFS teve impacto positivo e significativo sobre o nível de conhecimento dos agricultores em relação às práticas de produção e proteção de citrus. O teste-T mostrou diferença altamente significativa (P<0,05) no nível de conhecimento dos agricultores FFS dos não-FFS.

Risk factors for lung cancer in the Pakistani population.

BACKGROUND: Lung cancer is one of the most prevalent malignancies in the world and both incidence and mortality rates are continuing to rise in Pakistan. However, epidemiological studies to identify common lung cancer determinants in the Pakistani population have been limited. MATERIALS AND METHODS: In this retrospective case-control study, 400 cases and 800 controls were enrolled from different hospitals of all provinces of Pakistan. Information about socio-demographic, occupational, lifestyle and dietary variables was extracted by questionnaire from all subjects. Odd ratios (ORs) and 95% confidence intervals (CIs) were calculated. and dose-response associations were also assessed for suitable factors. RESULTS: Strong associations were observed for smoking (OR=9.4, 95%CI=6.9-12.8), pesticide exposure (OR=5.1, 95%CI=3.1-8.3), exposure to diesel exhaust (OR=3.1, 95%CI=2.1-4.5), red meat consumption (OR=2.9, 95%CI=1.8-4.7) and chicken consumption (OR=2.8, 95%CI=1.7-49). Other associated factors observed were welding fumes (OR=2.5, 95%CI=1.0-6.5), sedentary living (OR=2.0, 95%CI=1.6-2.6), family history (OR=2.0, 95%CI=0.8-4.9), wood dust (OR=1.9, 95%CI=1.2- 3.1), tea consumption (OR=1.8, 95%CI=1.2-2.6), coffee consumption (OR=1.8, 95%CI=1.1-2.8), alcoholism (OR=1.7, 95%CI=1.1-2.5) and asbestos exposure(OR=1.5, 95%CI=0.5-4.4). Consumption of vegetables (OR=0.3, 95%CI=0.2-0.4), juices (OR=0.3, 95%CI=0.3-0.4), fruits (OR=0.7, 95%CI=0.5-0.9) and milk (OR=0.6, 95%CI=0.5- 0.8) showed reduction in risk of lung cancer. Strongest dose-response relationships were observed for smoking (?2=333.8, p≤0.0000001), pesticide exposure (?2=50.9, p≤0.0000001) and exposure to diesel exhaust (?2=51.8, p≤0.0000001). CONCLUSIONS: Smoking, pesticide exposure, diesel exhaust and meat consumption are main lung cancer determinants in Pakistan. Consuming vegetables, fruits, milk and juices can reduce the risk of lung cancer risk, as in other countries.

Missense mutations (p.H371Y, p.D438Y) in gene CHEK2 are associated with breast cancer risk in women of Balochistan origin.

CHEK2 encodes a serine/threonine-protein kinase which plays a critical role in DNA damage signaling pathways. CHEK2 directly phosphorylates and regulates the functions of p53 and BRCA1. Most women with breast and/or ovarian cancer are not carriers of mutant BRCA1 or BRCA2. Multiple studies have shown that a CHEK2*1100delC confers about a two-fold increased risk of breast cancer in unselected females and a tenfold increase in males. Moreover, studies have shown that first-degree relatives of bilateral breast cancer cases who carried the CHEK2*1100delC allele had an eight-fold increased risk of breast cancer. It has been suggested that CHEK2 functions as a low-penetrance susceptibility gene for cancers and multiplies the risks associated with other gene(s) to increase cancer risk. The main goal of this study was to evaluate and to compare the role of truncating mutations, splice junction mutations and rare missense substitutions in breast cancer susceptibility gene CHEK2. Present study was performed on 140 individuals including 70 breast cancer patients both with and without family history and 70 normal individuals. Written consent was obtained and 3 ml intravenous blood was drawn from all the subjects. DNA was extracted from all the samples through inorganic method published already. Primers were synthesized for all the 14 exons of CHEK2 gene. Coding and adjacent intronic sequences of CHEK2 gene were amplified and sequenced. Two genetic variants (p.H371Y, p.D438Y) were found in exon 10 and exon 11 of gene CHEK2 which were not found in any of the 70 control individuals from same geographical area and ethnic group. The genetic variant c.1312G>T (p.D438Y) identified in a patient with a family history of breast cancer. To our knowledge, this is first mutation scanning study of gene CHEK2 from Balochistan population.

An audit of length of bone marrow trephine biopsies at a tertiary care hospital.

BACKGROUND: Bone marrow trephine biopsy is a well established minor surgical procedure for the inspection of bone marrow usually done along with bone marrow aspiration. The objective of this study was to evaluate the length of trephine biopsies and the rate of positivity for diagnosis as well as unfit biopsies in various length ranges. METHODS: This retrospective study was conducted at Fauji Foundation Hospital and Foundation University Medical College Rawalpindi from Jan 2007 to Dec 2009. A total of 394 trephine biopsy reports were collected and reviewed. The criterion for adequate trephine biopsy was > or = 1.5 Cm. The biopsies were divided into four groups according to length, i.e., group-1: > or = 1.5 Cm, group-2: 1-1.4 Cm, group-3: 0.5-0.9 Cm, and group-4: < 0.5 Cm. The adequacy of trephine biopsy length and rate of positive diagnosis as well as unfit biopsies were compared. RESULTS: Total 394 trephine biopsies were reviewed. Group-1 included 88 biopsies and 87 (98.9%) had positive diagnosis. Group-2 included 137 biopsies and 133 (97.1%) had positive diagnosis. Group-3 included 99 biopsies and 91 (92%) had positive diagnosis. Group-4 included 70 biopsies and 57 (81.4%) had positive diagnosis. There was no significant difference between group-1 and group-2 for the rate of positivity of diagnosis (p = 0.65). In group-1, 1 (1.1%) was unfit for evaluation, in group-2, 4 (2.9%) were unfit, in group-3, 8 (8%) were unfit, and in group-4, 13 (18.5%) were unfit for evaluation. Total 26 trephine biopsies were unfit for evaluation, out of which 13 (50%) belonged to group-4. Trephine biopsies that were unfit for evaluation were 4 (4.9%) in 2007, 17 (10.5%) in 2008, and 5 (3.3%) in 2009. CONCLUSION: Although 22.3% biopsies were of recommended length there was no significant difference in rate of positive diagnosis between biopsies of > or = 1.5 Cm and 1-1.4 Cm.

Pattern of childhood malignancies: study of 922 cases at Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan.

OBJECTIVE: To determine the pattern of childhood cancer in northern Pakistan. DESIGN: A descriptive study. PLACE AND DURATION: January 1992 to December 2001 at the Armed Forces Institute of Pathology, Rawalpindi, Pakistan. MATERIALS AND METHODS: All histologically diagnosed malignant childhood tumours registered with the tumour registry of our institute were retrieved from the case files. Basic epidemiological data regarding each case were collected from the request forms and analysed for the site of involvement, age distribution and histological types of tumour. RESULTS: During the ten year study period a total of 922 childhood malignancies, constituting 4.3% of all malignant tumours, were seen. Haematological malignancies (lymphomas and leukaemias) were the commonest, accounting for 50.4% in males and 37.7% in females. The haematological malignancies were followed by tumours of bone (6.3%), CNS (6.3%), and eye (4.84%) in males and soft tissue tumours as 5th common in females. Skin, renal and colorectal tumours were also in the ten commonest in both sexes and so were ovarian tumours in females. CONCLUSIONS: Lymphomas and leukaemias are the main bulk of childhood cancer. Malignant tumours were twice more common in males than females in this series.

Usefulness of crush smears intraoperative consultaion of neurological biopsis.

OBJECTIVE: To evaluate accuracy of intraoperative crush smears diagnosis of neurosurgical biopsies. DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: The Armed Forces Institute of Pathology, Rawalpindi, from February 2002 to February 2003. PATIENTS AND METHODS: One hundred, neurosurgical biopsies were received for intraoperative consultation over a period of one year. Clinical information regarding age, gender, history, and CT scan or MRI findings were recorded. Crush smears were prepared, fixed in 95% alcohol and stained with rapid haemotoxylin and eosin (H&E) stains. Diagnosis was categorized into inflammatory, benign and malignant tumours. Remaining tissue was fixed overnight in 10% formalin for histological sections. Permanent H&E sections were used as the gold standard. The average time required for intraoperative cytological diagnosis was 8 minutes. RESULTS: Out of 100 neurosurgical biopsies, crush smears of 94 were considered suitable for interpretation. There were 8 inflammatory, 41 benign and 41 malignant tumours, including 4 inconclusive. Eightyfour of the crush smears diagnosis agreed with the histological diagnosis. Overall diagnostic accuracy of crush smears was 93.3%. Diagnosis of inflammatory, benign and malignant tumours showed specificity of 98.7%, 96% and 94%, and a sensitivity of 70%, 97.5% and 95% respectively. CONCLUSIONS: Crush smears are useful in the intraoperative diagnosis of space occupying lesions of central nervous system. The crush smears cytology was found highly reliable, rapid and inexpensive mode of intraoperative diagnosis.

Urothelial neoplasia of the urinary bladder--comparison of interobserver variability for WHO Classification 1972 with WHO/ISUP Consensus Classification 1998.

BACKGROUND: Classification of urothelial bladder tumours is an important factor in the treatment and prognosis of these lesions. Over the years many classifications have been proposed for this purpose. The objective of this study was to classify urothelial neoplasms of the urinary bladder using the latest WHO/ISUP Consensus Classification 1998 and WHO Classification 1972 and compare the two regarding interobserver variability. METHODS: This study included 100 consecutive biopsy specimens of urothelial neoplasms of the urinary bladder diagnosed at the department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi. These were classified according to WHO Classification 1972 and WHO/ISUP Consensus Classification 1998 by 2 groups of pathologists independently. The tumour categories for WHO classification 1972; papilloma, and transitional cell carcinoma (TCC) grades I, II and III were compared with the WHO/ISUP Consensus Classification entities of papilloma, papillary neoplasm of low malignant potential, low grade and high grade papillary carcinomas. Kappa statistics were used to evaluate interobserver variability. Chi square test was used to calculate significance. RESULTS: There was agreement on 80 tumours between the two groups of histopathologists when using WHO classification 1972 while there was agreement on 95 tumours using WHO/ISUP consensus classification. The value of Kappa for WHO Classification was 0.68 (good agreement) whereas for WHO/ISUP Consensus Classification it was 0.91 (excellent agreement). The difference between the two systems was statistically significant (p<0,001). Kappa values were less for benign and borderline lesions using both systems. CONCLUSIONS: WHO/ISUP Consensus Classification 1998 showed less interobserver variability than WHO Classification 1972 in the evaluation of bladder tumours. It was found easier to apply by both groups. There was less agreement on the benign and borderline lesions using both the classifications.