Depression and diabetes: An experience from Kashmir.

BACKGROUND: Diabetes mellitus is a common chronic metabolic disorder characterized by hyperglycemia. Minimal attention has been paid toward the relationship between diabetes and depression in developing countries such as India, despite a number of studies in developed countries, exploring casual pathway between the two highly prevalent conditions. The aim of this study was to estimate the prevalence and severity of depression among patients of diabetes attending the endocrinology department of a tertiary care hospital of Kashmir. METHODOLOGY: A total of 527 patients having diabetes of ≥6 months with age ranging from 18 years to 60 years were screened for major depressive disorder (MDD) using Diagnostic and Statistical Manual IV-based criteria. Severity of depression was assessed by the Montgomery-Asberg Depression Rating Scale. RESULTS: Depression was present in 39.65% of patients. Depression was more prevalent in the age group of 29-38 years, in females as compared to males, among literates and government employees. Prevalence of depression among Type 1 diabetic patients was 60%, while as in case of Type 2, it was 37.75%. Depressed patients had higher fasting blood glucose levels as compared to nondepressed diabetic patients. CONCLUSION: MDD is inordinately high among adult diabetic patients, and majority of the depressive patients have moderate intensity of MDD.

Histopathological Pattern Of Soft Tissues Tumors And Tumour Like Lesions In The Pathology Department Of Lady Reading Hospital Peshawar, Pakistan.

BACKGROUND: Soft tissues tumours are tumours of mesenchymal origin excluding epithelial, skeletal tissue, reticuloendothelial system, brain coverings and solid viscera of the body. The objective of this study was to know the histopathological pattern of soft tissues tumours in the Pathology Department of Lady Reading Hospital Peshawar Khyber Pakhtunkhwa Pakistan. METHODS: This descriptive study was conducted on retrospective data from January 2009 to December 2013. All the soft tissues biopsy specimens were received in 10% formalin, labelled, gross performed, sections processed in alcohol, xylene, wax, block prepared, frozen, microtome sections taken and processed for H&E staining, mounted and reported by a Histopathologist. The inclusion criteria were any sufficient soft tissue tumour biopsy specimen of any age, sex, location in body whereas the exclusion criteria were autolysed biopsy specimen. A minimum of four and maximum of eight sections and 5 micron thick were taken from each specimen. RESULTS: A total of 267 soft tissues tumours biopsy specimens were received in the pathology laboratory with age range of 1-75 years, with mean age of 30.68±17.71 years. Male to female ratio was 1.13:1. Amongst the total, benign tumours were 176 (65.91%). Haemangioma, 73 (27.3%) was the commonest tumours followed by lipomas 41 (15.4%) cases. Amongst the total malignant tumours, i.e., 91 (34.08%), rhabdomyosarcoma, 35 (13.1%) was the commonest tumour followed by angiosarcoma 14 (5.2%) cases. CONCLUSIONS: Haemangioma is the commonest benign tumour and rhabdomyosarcoma is the commonest malignant tumour in this study.

Anti-inflammatory activities of Taxusabietane A isolated from Taxus wallichiana Zucc.

Current study was conducted to identify constituents of Taxus wallichiana Zucc. that might be responsible for its folk use in anti-inflammatory conditions. Taxusabietane A was isolated from the bark extract of Taxus wallichiana Zucc. Taxusabietane A was analyzed for in-vitro and in-vivo anti-inflammatory activities using Lipoxygenase (LOX) inhibition assay and carrageenan-induced paw edema model. Taxusabietane A revealed considerable LOX inhibitory activity with the IC(50) value being 57 ± 0.31. Standard compound Baicalein showed the IC(50) value being 22.1 ± 0.03 µM. Taxusabietane A also showed significant (5 and 10 mg/kg) anti-inflammatory activity induced by carrageenan. However, this study highlighted the potential of Taxusabietane A to be further explored as a new lead compound for management of conditions associated with inflammation.

Molecular simulations of Taxawallin I inside classical taxol binding site of ß-tubulin.

A new taxoid Taxawallin I (1) along with two known taxoids (2-3) were isolated from methanolic bark extract of Taxus wallichiana Zucc. Structural characterization was confirmed by mass and NMR spectral techniques. Taxawallin I exhibited significant in-vitro anticancer activity against HepG2, A498, NCI-H226 and MDR 2780AD cancer lines. Tubulin binding assay was performed to assess its tubulin binding activity. Molecular docking analysis was performed to study the potential binding mode inside the taxol binding site of ß-tubulin.

Malignant smooth muscle tumours of soft tissue--a demographic and clinicopathological study at a tertiary care hospital.

OBJECTIVE: To determine the demographic characteristics and distribution of various reported prognostic factors of leiomyosarcoma (LMS) among subjects reporting to histopathology diagnostic centers of Aga Khan University (AKU) all over Pakistan between 2000-2004. METHODS: This study analyzed 205 consecutive confirmed cases of LMS received during a period of four years. The data regarding age, sex and size of tumor was obtained from the pathology medical records. Data on grade and positivity of immunohistochemical stains was assessed and all the variables analyzed using SPSS version 12.5. RESULTS: Of the 205 specimens of LMS, 31 were received as blocks for second opinion. A hundred specimens were multiple fragments, and 74 were intact masses. Of the latter, 40% had clear margins. The mean size of the tumor was 7.23 cms. (95% CI 6.1; 8.4). There were no cases of childhood LMS. Teenage LMS comprised 3% of all tumors. Grade 1 tumors were 16.6% of the total, 56.6% were grade 2, and 8.5% were grade 3. Vimentin positivity was observed in 97% of the tumors, desmin positivity in 56.7%, HHF35 positivity in 81.0%, s-100 positivity in 15.6% and cytokeratin positivity in 11% of the cases. The median age of LMS patients was 48.4 years, the mean age was 48.6 years (95% CI 45.9; 50.8) and male to female ratio was 1:1.2. The malignancy occurred a decade earlier in the females as compared to the males. The mean age of male cases was 52.3 years (95% CI 48.8; 55.8); and of females was 45.2 years (95% CI 41.8; 48.6). The mean age of teenage LMS was 17.2 years (95% CI 15.6; 18.7). The most common symptom was a painless swelling. The most common sites were lower limb (24.4%) and pelvis (24.4%) followed by abdomen (20.6%) and head and neck (12.7%). The least common sites were upper limb and chest (8.0% each). Seventy five percent of the tumors with involved margins were more than 5.0 cms. in size whereas 47% of tumors with free margins were above 5.0 cms. in size. Approximately half the tumors in the males were less than 5.0 cms, as compared with 31.0% in the females. LMS in the extremities was equally common in both genders, but trunk LMS was nearly twice as common in the females. CONCLUSION: In our population, leiomyosarcoma occurs at a relatively younger age, has a late presentation; is more common in females as compared to males and usually excised incompletely. No genetic study for LMS has been published in Pakistan; these studies are recommended to determine the biological pattern of LMS in our population.

Immunophenotypic characterization of high grade pleomorphic sarcomas: a demographic and immunohistochemical study in a major referral center of Pakistan.

OBJECTIVE: Immunophenotypic characterization of high grade (pleomorphic) sarcomas and determination of their frequency, mean/median age, sex preferences and common sites in Pakistani patients. METHODS: This study included 134 consecutive cases of high grade (pleomorphic) sarcomas diagnosed in adults above the age of 15 years in the section of histopathology at theAga Khan University Hospital, Karachi during a period of two years. These high grade (pleomorphic) sarcomas were immunophenotyped using a panel including antibodies against Vimentin, Desmin, Smooth muscle Actin, S 100, CD34, CD68 and Cytokeratin etc by indirect immunoperoxidase. RESULTS: Of the 134 cases which were characterized, 38.1% were pleomorphic leiomyosarcoma, followed by pleomorphic rhabdomyosarcoma 14.9%, Malignant Peripheral Nerve Sheath Tumour 9%, pleomorphic liposarcoma 3.7% and pleomorphic storiform Malignant Fibrous Histiocytoma 0.7%. Thirty three percent of cases could not be characterized further. Mean/ median age for Leiomyosarcoma was 50/50, for Rhabdomyosarcomas 33/22, for MPNST 42/41, for Liposarcoma 52/50 and for Malignant Fibrous Histiocytoma 46/46 respectively. The commonest site for leiomyosarcoma was lower limb (43%), for rhabdomyosarcoma head and neck (42%), for MPNSTthorax (36.4%) and for liposarcoma abdomen (50%). CONCLUSION: It was concluded that the most common pleomorphic sarcoma occurring in our adult population was Leiomyosarcoma, and that immunohistochemical stains are essential in most cases for further characterization of pleomorphic high grade sarcoma.