Smoking and blood pressure levels in hypertensive patients: evaluating the role of gender, age and hypertension duration

Background: Hypertension is estimated to affect about 40% of adults above 25 years of age globally. While many of the risk factors of hypertension are well known, such is not the case with smoking. Pertinent published literature is heterogeneous, with a dearth of relevant local data. Objectives was to study the relationship between smoking and blood pressure levels in hypertensive patients and to assess the effects of gender, age and hypertension duration on such a relationship.Methods: A cross-sectional study was carried out on a total of 298 conveniently sampled patients, aged 18 or above, from the medical outpatient department of a secondary care hospital of Karachi. The relevant data were collected by means of a structured questionnaire whereas the blood pressure level was checked using sphygmomanometer with stethoscope. Mann Whitney U test was used for inferential analysis whereas the significance level was set at 0.05.Results: Overall, both the systolic and diastolic blood pressure levels were significantly associated with smoking history (p<0.05 for both) where they were found to be higher in smokers than in non-smokers. Furthermore, after gender, age and hypertension duration based stratifications; both the systolic and diastolic blood pressure levels were still significantly associated with smoking history in patients who were male, were ≥35 years old and had <5 years hypertension duration (p<0.05 for both) where they were again found to be higher in smokers than in non-smokers.Conclusions: The study results showed a significant association of positive smoking history with higher mean systolic and diastolic blood pressure levels, though after stratifying for gender, age and hypertension duration, this relationship persisted only in patients who were male, were ≥35 years old and had <5 years hypertension duration.

Microorganisms and viruses causing diarrhea in infants and primary school children and their relation with age and sex in Zakho city, Kurdistan Region, Iraq.

Background: Diarrheal diseases in children are a major public health concern in developing countries. Diarrheal infection spreads through contaminated food or drinking-water, or from person-to-person as a result of poor hygiene. This study was conducted to investigate the incidence of different microorganisms associated with diarrhea in infants and primary school children and their relation to sex and age in Zakho city, Kurdistan region, Iraq. Methods: During the period from September 2013 to May 2014, 600 diarrheic samples were collected from both sexes and different ages (<2 to 12) years; these samples were subjected to various diagnostic tests in the Microbiology Laboratories/Biology Department/Faculty of Science/University of Zakho. Results: Out of 600/479 were positive for one or more types of microorganisms including 265 (55.32%) males and 214 (44.67%) females. Among the positive 479 samples, the highest rate of prevalence was with both bacteria and parasites (57.33and 57.00%, respectively), followed by viruses (10.33%) and only1.16% with fungi. The most prevalent enteric microorganisms were found to be E. coli (62.5%), followed by E. histolytica (46.19%), G. lamblia (42.10%) and the lowest H. nana (0.87%). The mixed prevalence were documented in 179 (37.36) cases, with the most common correlation between bacteria and parasites in 76 (42.45 %) cases. All ages showed high rates of prevalence with both bacteria and parasites, the highest bacterial cases being among ages >4-8 years (65.38 and 64.07%), while parasites were among >6-10 years (64.67 and 60.11%). High viral prevalence were recorded among ages <2 to 6 years with the peak among <2 years (40.54%). Conclusions: From this study we conclude that about 57% of diarrheal cases were associated with bacteria, parasites, and viruses with E. coli, E. histolytica, G. lamblia and rotavirus as leading microorganisms. The mixed prevalence with two or more microorganisms was documented in 179 (37.36%) out of 479 positive samples and the rate of microbial prevalence was found to be gender and age dependent.

Micro-ultrastructure features of liver in Chinese Taihe black-bone silky fowl (Gallus gallus domesticus Brisson) / Características ultraestructurales de hígado en la gallina silky China Taihe de hueso negro (Gallus gallus domesticus Brisson)

In this work, the morphological features of liver in Chinese Taihe black-bone silky Fowl (BSF) were analyzed by light microscope and transmission electron microscopy. The results showed that two kinds of hepatocytes were present in Taihe BSF liver, i.e., the dark and the light hepatocyte. The dark hepatocyte was electron-dense and lager, with many organelles, mitochondria especially. The light hepatocytes were smaller than the dark. They had electron-lucent cytoplasm with a small number of organelles. Furthermore, there were lipolysosomes in the light hepatocyte. The numerous long and serried finger-like microvilli spread into bile canaliculus lumen. The glycogen granules intensely stained, spread in some hepatocytes. Numerous glycogen granules scattered in cytoplasm especially near bile canaliculi. However, lipid droplets were not observed in any hepatocytes. The natural apoptotic hepatocytes were observed in Taihe BSF liver. The hepatocytes which contain abundant uesicae-like endoplasmic reticulum closed the apoptotic hepatocytes and spread the process to approach the cell residual bodies. Besides, there was a macrophage with several phagosomes. In conclusion, the dark and the light hepatocyte were present in Chinese Taihe BSF liver. They were different from electron-dense and organelles. The hepatocytes of Taihe BSF could undergo natural apoptosis, regeneration and renew ability.

Fueron analizadas las características morfológicas ultraestructurales de hígado en la gallina sedosa china de hueso negro por microscopía óptica y microscopía electrónica de transmisión. Los resultados mostraron que se encontraron hepatocitos claros y oscuros en el hígado de la gallina china Taihe. El hepatocito oscuro era denso y de mayor tamaño. Tenía numerosos organelos, especialmente mitocondrias. Los hepatocitos claros eran más pequeños que los oscuros. El citoplasma presentó un pequeño número de organelos. Además, había lipolisosomas en los hepatocitos claros. Numerosas microvellosidades se extendían hacia los canalículos biliares. En algunos hepatocitos se observó una tinción marcada en los gránulos de glucógeno. Sin embargo, no se observaron gotas de lípidos en los hepatocitos. Se observaron los hepatocitos apoptóticos naturales en el hígado de la gallina Silky Taihe. Aquellos hepatocitos que contenían abundante retículo endoplásmico, cerraban los hepatocitos apoptóticos y extendían el proceso de acercamiento a cuerpos residuales celulares. También hubo un macrófago con varios fagosomas. En conclusión, los hepatocitos claros y oscuros estaban presentes en el hígado de la gallina Taihe china. Estos diferían de electrones de alta densidad y organelos. Los hepatocitos de la gallina Taihe presentaron una apoptosis natural y capacidad de regeneración.

retrospective study of testicular relapse in acute lymphoblastic leukemia

Testicular relapse in ALL usually appear as painless testicular enlargement mostly unilateral. Diagnosed by wedge biopsy. The testis is a frequent site of relapse. To find out the incidence of testicular relapse in ALL, time of diagnosis of testicular relapse, age group more commonly associated with testicular relapse, the association of testicular relapse with other relapses [medullary or extra-medullary], and prognosis of patients with testicular relapse. Aretrospective study in the central teaching hospital of children in Baghdad- unit of hematology and oncology, during January 2000 - December 2006. Two hundred-four males were studied retrospectively. Informations were obtained from patients' files. The incidence of testicular relapse was in 18 patients represented [8.8%] of total cases of boys with ALL below 15 years. Relapse is mainly unilateral in 15 patients [83.3%] and mostly in the right side in 11 patients [61.1%] of total cases with testicular relapse. There is no significant statistical incidence of relapse with the age of patient represented by 2 cases [6.2%] from [0-2 years], 11 cases [8.2%] from [2-10 years], and 5 cases [13%] more than [10 years]. Time of diagnosis of relapse was mainly during the oral maintenance therapy [13] patients [72.5%]. Testicular relapse was isolated in 8 patients [44%] and combined with other relapses in 10 patients [56%] of them 7 patients [39%] with bone marrow relapse and 3 patients [17%] with CNS relapse. The outcome of patients with testicular relapse was better after discontinuation of chemotherapy "after three years of treatment" [2 cases diagnosed with relapse both of them still alive] represented [100%], while during the maintenance therapy of 13 patients, 6 [46.2%] of them still alive, 6 patients [46.2%] of them died, and 1 patient [7.6%] with no report, while induction chemotherapy 2 cases 1 [50%] alive and 1 [50%] died]. Patients with isolated testicular relapse had better outcome represented by 6 patients [75%] still alive and 2 patients [25%] died, patients with combined relapse had worse outcome, represented by 3 patients [30%] alive, 5 patients [50%] died, and 2 patients [20%] with no report. Incidence of testicular relapse significantly decreased after the introduction of more intensive chemotherapy in Jan 2004 from 9.8% to 3.1%. Incidence of testicular relapse decrease with introduction of intensive chemotherapy and had higher incidence during the maintenance therapy, associated with increased incidence with other medullary and extra-medullary relapses, and has better prognosis when it is late and isolated than for early and combined relapse

Fibroscore for the non-invasive assessment of liver fibrosis in chronic viral hepatitis

To evaluate the predictive value of a set of laboratory markers for the assessment of liver fibrosis in chronic viral hepatitis patients. Cross-sectional study. Baqai Medical University, Combined Military Hospital, Malir, Karachi, from November 2006 to May 2008. Twenty laboratory parameters were measured in 100 treatment-na‹ve chronic viral hepatitis patients who also had liver biopsy performed. Descriptive statistics, areas under the ROC's curves, and multivariate logistic regression analysis identified a fibrosis panel, a set of five most useful markers, for the assessment of stages of fibrosis, stage 0 to stage 4. The fibrosis index, FibroScore, consisted of bilirubin, Gamma glutamyl transferase, Hyaluronic acid, alpha 2 macroglobulin, and platelets evaluation. A score of>0.5 predicted stages 2, 3 and 4, with a sensitivity of 82%, and specificity of 92%. A score>0.5 for stages 3 and 4 had a sensitivity of 85%, and specificity of 89%. At a score of>0.80, for stages 3 and 4, the sensitivity was 70%, specificity was 97%, and PPV 87% [there was>85% possibility of presence of stage 3 or 4]. A score of<0.20 predicted the absence of stages 2, 3, and 4 with a sensitivity of 91%, specificity of 86%, and NPV of 96%. Scores from 0.00 to 0.10 almost certainly ruled out the presence of stages 2-4 [NPV=98%]. The areas under the ROC curve were: 0.808 for stage 2; 0.938 for stage 3; and 0.959 for stage 4. A combination of 5 markers is very useful in predicting various stages of liver fibrosis, and is helpful in the non-invasive assessment of liver fibrosis in chronic viral hepatitis patients

Gastric leiomyosarcoma: first case report from the Kingdom of Bahrain and review of literature

Gastric leiomyosarcoma are very rare tumors. We are reporting the first case of gastric leiomyosarcoma diagnosed in Bahrain and documented in the cancer registry. Unfortunately, the patient died due to rapidly progressing nature of the disease despite the multimodality treatment

case of tinea saginata [tape worm] infestation of the uterus presenting with abnormal vaginal bleeding

There are many reported causes of abnormal uterine bleeding. We report an unusual case of uterine bleeding caused by tapeworm infestation, mimicking retained products of conception in a 35 year old multipara

Dyspepsia in a rural cohort

To determine the etiology of dyspepsia in the rural population of the province of Sindh, Pakistan. Design: Observational study. Place and Duration of Study: The study was carried out at Baqai Medical University and spread over three years from May 1998 to April 2001. Patients and All patients of age 14 and above, presenting with dyspepsia for the first time, were endoscoped and histopathological details of the susceptible as well as normal looking mucosa were obtained. A total of 446 patients, 206 males and 240 females, presenting with dyspepsia were studied. Male to female ratio was 0.9: 1.1 and mean age was 38.86 years [SD 15.52]. Overall, 59.9% [n=446] had gastritis and 9.2% had combination of gastritis and other pathologies. 15.2%, 44 females and 22 males had normal endoscopy. Histology revealed gastritis in 75% [51] and 3.81% had normal endoscopy and normal histology. Peptic ulcer accounted for 9.5%, while 1.57% had oesophageal varices and 0.44% had gastropathy and oesophageal varices. Gastritis is the commonest cause of dyspepsia in a rural population of Sindh. Peptic ulcer is significantly uncommon accounting for only 9.5%. Gastritis is responsible for considerable morbidity leading to poor quality of life and socioeconomic setback

Neoadjuvant chemotherapy and radiotherapy versus radiotherapy alone in patients with advanced nasopharyngeal carcinoma

A randomized study was carried out between January 1987 and December 1993 at the Kuwait Cancer Control Centre, to evaluate the efficacy of neoadjuvant chemotherapy and radiotherapy over radiotherapy alone inpatients with locally advanced nasopharyngeal carcinoma. Forty three patients were randomized to recive either neoadjuvant chemotherapy and radiotherapy [Combination arm] or radiotherapy alone. All the patients had stage IV disease. The tolerance to combination arm was inferior to that of radiation arm. There was no difference in the locoregional control rate between the two arms. Response rate following chemotherapy was 88%, which increased to 94% following radiotherapy. The overall response rate in the radiotherapy arm alone was 95%. At the median one of year of the follow up the failure rate in the radiotherapy arm was 26% and in the combination arm 24%. Three patients in the combination arm and two patients in the radiotherapy arm developed distant metastses

Intraluminal radiother for symptomatic treatment of carcinoma of the bronchus

The palliative management of patients with advanced carcinoma of the bronchus through intraluminal radiotherapy is addressed. A59 year old male presented with symptoms of cough, haemoptysis, dyspnea and obstructive pneumonitis. Chest radiographys and CT Scan showed collapse of the right lung with enlargement of the paratrcheal nodes. Bronshoscopy revealed a growth extending from the distal trachea to the proximal right main bronchus. The biopsy diagnosis confirmed the presence of squamous cell carcinoma. A five-week course of external radiotherapy did not achieve desired and subjective and objective responses. Two fractions of intraluminal radiotherapy were given a week apart, following two weeks of external radiotherapy. The dose was 500 cGy, which was delivered at one cm from the source. Bronchoscopy one month after the intraluminal radiotherapy showed no evidence of tumor. The patient has remained subjectively and objectively disease free for 10 months folloeing the treatment. Intraluminal radiotherapy gives lasting symptomatic relief in patients with carcinoma of the lung associated with intraluminal disease

Radiotherapy in the management of metastatic spinal cord compression

Presentation and results of metastatic spinal cord compression [MSCC] treated with radiotherapy at Salmaniya Medical Complex [SMC] between July and December 1997 are reported. Out of 96 cancer patients who were treated with radiotherapy, 12 [12.5%] patients had MSCC. This incidence of MSCC was higher than the incidence in the literature. Five patients were ambulatory, three patients had mono/para paresis and four patients had paraplegia berfore the treatment. Radiotherapy dose ranged from 40 Gy in 20 fraction to 20 Gy in 5 fraction. Following radiotherapy patients who presented with mono/paraparesis regained the ambulation and patients who had no neurological signs at presentation maintained ambulation till the last follow up [median 5 months]. Neurological improvement in patients with paraplegia was not enough to make them ambulatory. Compared to earlier reports of MSCC treated with surgery at SMC, there appeared to be an increase in the number of patients with MSCC and its diagnosis at early stage. Radiotherapy was effective in preventing paraplegia in patients with MSCC who were diagnosed and referred early for management. The increase in the number of MSCC as factual or a reference pattern should be assessed in long term analysis