Comparative analysis of dural substitute autologous vs. semisynthetic collagen-based dura graft.

OBJECTIVE: The aim of the present study is to evaluate the success rate and safety of both auto-grafts and collagen-based semi-synthetic grafts in patients with dura defects. PATIENTS AND METHODS: A prospective comparative study was conducted at the neurosurgery departments of different hospitals in Peshawar and Faisalabad. Patients were divided into two groups: A (autologous graft) and B (semi-synthetic graft). Dura graft autologous was applied in one group of patients with supratentorial brain surgery. Fascia lata was used, harvested from the lateral thigh, 3 to 5 cm long incision at the junction of the upper and middle one-third of the upper leg. A bone flap was implanted in the subcutaneous region in the abdominal part. Perioperative antibiotics were given to all the patients, and surgical drains placed intraoperatively were removed after 24 hours of surgery. In the second group, semi-synthetic dura grafts of 2.5x2.5 cm and 5x5 cm 7.5x7.5 cm sizes were used. Statistical analysis was performed using SPSS version v.20. Student's t-test was performed for the two groups to compare categorical variables, and the data were considered statistically significant at p > 0.05. RESULTS: In this study, 72 patients of both genders were recruited. We observed that the Semi-synthetic collagen matrix had less surgical time. The mean difference in surgical duration was observed as 40 minutes. However, both groups reported statistically significant differences in terms of surgical duration (< 0.001). No case of infection was reported in both groups. The overall mortality ratio was 12%. Two male deaths were recorded due to cardiovascular disorders, while one death of a 42-year male was also recorded. CONCLUSIONS: Based on the above findings, it may be concluded that using a semi-synthetic collagen substitute for dura repair is a simple, safe, and effective alternative to the autologous graft for dura repair in dura defects.

Range of factors in the reduction of hyperhydricity associated with in vitro shoots of Salvia santolinifolia Bioss / Gama de fatores na redução da hiperidricidade associada a brotos in vitro de Salvia santolinifolia Bioss

Abstract Hyperhydricity is a serious physiological disorder and affects In vitro propagation of many plants and as well of Salvia santolinifolia. The donor material to initiate the in vitro culture was the callus taken from the in vitro shoots produced on Murashig and Skoogs (MS) medium at 4.0 mg/l BA. This callus formed numerous hyperhydric shoots on culturing upon the medium of the same composition. The aim was to systematically evaluate the effect of cytokinins (Benzyladnine (BA) and N6-(-2-isopentenyl) adenine (2iP), culture vessels magnitude, medium solidification, source of nitrogen and calcium chloride for the alleviation of hyperhydricity. In the tissue cultures of S. santolinifolia BA and 2iP induced severe hyperhydricity, when other factors i.e. culture vessels magnitude and a suitable concentration of agar, ammonium nitrate (NH4NO3), potassium nitrate (KNO3) & calcium chloride (CaCl2.2H2O) were not optimized. After 30 days' culture, we observed 83.82% hyperhydric shoots at increased level (1.5 mg/l 2iP) and 81.59% at decreased levels (1.0 mg/l 2iP). On the other hand, hyperhydricity percentage at decreased (0.4%) and at increased (0.8%) levels of agar were 72.37% and 39.08%, respectively. MS medium modification with NH4NO3 (412 mg/l), KNO3 (475 mg/l) and CaCl2.2H2O (880 mg/l) was found the best medium to reduced hyperhydricity (23.6%).

Resumo A hiperidricidade é um distúrbio fisiológico sério e afeta a propagação in vitro de muitas plantas e também da Salvia santolinifolia. O material doador para iniciar a cultura in vitro foi o calo retirado dos brotos in vitro produzidos em meio Murashig e Skoogs (MS) a 4,0 mg / l BA. Esse calo formou numerosos rebentos hiperídricos em cultura no meio da mesma composição. O objetivo foi avaliar sistematicamente o efeito das citocininas (Benziladnina (BA) e N6 - (- 2-isopentenil) adenina (2iP), magnitude dos vasos de cultura, solidificação do meio, fonte de nitrogênio e cloreto de cálcio para o alívio da hiperidricidade. culturas de tecidos de S. santolinifolia BA e 2iP induziram hiperidricidade severa, quando outros fatores, como magnitude dos vasos de cultura e uma concentração adequada de ágar, nitrato de amônio (NH4NO3), nitrato de potássio (KNO3) e cloreto de cálcio (CaCl2.2H2O), não foram otimizados. Após 30 dias de cultura, observamos 83,82% de brotos hiperídricos em níveis aumentados (1,5 mg / l 2iP) e 81,59% em níveis reduzidos (1,0 mg / l 2iP). Por outro lado, a porcentagem de hiperidricidade diminuiu (0,4%) e em níveis aumentados (0,8%) de ágar foram 72,37% e 39,08%, respectivamente. A modificação do meio MS com NH4NO3 (412 mg / l), KNO3 (475 mg / l) e CaCl2.2H2O (880 mg / l) foi encontrada melhor hiperidricidade média a reduzida (23,6%).

Range of factors in the reduction of hyperhydricity associated with in vitro shoots of Salvia santolinifolia Bioss / Gama de fatores na redução da hiperidricidade associada a brotos in vitro de Salvia santolinifolia Bioss

Hyperhydricity is a serious physiological disorder and affects In vitro propagation of many plants and as well of Salvia santolinifolia. The donor material to initiate the in vitro culture was the callus taken from the in vitro shoots produced on Murashig and Skoogs (MS) medium at 4.0 mg/l BA. This callus formed numerous hyperhydric shoots on culturing upon the medium of the same composition. The aim was to systematically evaluate the effect of cytokinins (Benzyladnine (BA) and N6-(-2-isopentenyl) adenine (2iP), culture vessels magnitude, medium solidification, source of nitrogen and calcium chloride for the alleviation of hyperhydricity. In the tissue cultures of S. santolinifolia BA and 2iP induced severe hyperhydricity, when other factors i.e. culture vessels magnitude and a suitable concentration of agar, ammonium nitrate (NH4NO3), potassium nitrate (KNO3) & calcium chloride (CaCl2.2H2O) were not optimized. After 30 days' culture, we observed 83.82% hyperhydric shoots at increased level (1.5 mg/l 2iP) and 81.59% at decreased levels (1.0 mg/l 2iP). On the other hand, hyperhydricity percentage at decreased (0.4%) and at increased (0.8%) levels of agar were 72.37% and 39.08%, respectively. MS medium modification with NH4NO3 (412 mg/l), KNO3 (475 mg/l) and CaCl2.2H2O (880 mg/l) was found the best medium to reduced hyperhydricity (23.6%).

A hiperidricidade é um distúrbio fisiológico sério e afeta a propagação in vitro de muitas plantas e também da Salvia santolinifolia. O material doador para iniciar a cultura in vitro foi o calo retirado dos brotos in vitro produzidos em meio Murashig e Skoogs (MS) a 4,0 mg / l BA. Esse calo formou numerosos rebentos hiperídricos em cultura no meio da mesma composição. O objetivo foi avaliar sistematicamente o efeito das citocininas (Benziladnina (BA) e N6 - (- 2-isopentenil) adenina (2iP), magnitude dos vasos de cultura, solidificação do meio, fonte de nitrogênio e cloreto de cálcio para o alívio da hiperidricidade. culturas de tecidos de S. santolinifolia BA e 2iP induziram hiperidricidade severa, quando outros fatores, como magnitude dos vasos de cultura e uma concentração adequada de ágar, nitrato de amônio (NH4NO3), nitrato de potássio (KNO3) e cloreto de cálcio (CaCl2.2H2O), não foram otimizados. Após 30 dias de cultura, observamos 83,82% de brotos hiperídricos em níveis aumentados (1,5 mg / l 2iP) e 81,59% em níveis reduzidos (1,0 mg / l 2iP). Por outro lado, a porcentagem de hiperidricidade diminuiu (0,4%) e em níveis aumentados (0,8%) de ágar foram 72,37% e 39,08%, respectivamente. A modificação do meio MS com NH4NO3 (412 mg / l), KNO3 (475 mg / l) e CaCl2.2H2O (880 mg / l) foi encontrada melhor hiperidricidade média a reduzida (23,6%).

Range of factors in the reduction of hyperhydricity associated with in vitro shoots of Salvia santolinifolia Bioss

Abstract Hyperhydricity is a serious physiological disorder and affects In vitro propagation of many plants and as well of Salvia santolinifolia. The donor material to initiate the in vitro culture was the callus taken from the in vitro shoots produced on Murashig and Skoogs (MS) medium at 4.0 mg/l BA. This callus formed numerous hyperhydric shoots on culturing upon the medium of the same composition. The aim was to systematically evaluate the effect of cytokinins (Benzyladnine (BA) and N6-(-2-isopentenyl) adenine (2iP), culture vessels magnitude, medium solidification, source of nitrogen and calcium chloride for the alleviation of hyperhydricity. In the tissue cultures of S. santolinifolia BA and 2iP induced severe hyperhydricity, when other factors i.e. culture vessels magnitude and a suitable concentration of agar, ammonium nitrate (NH4NO3), potassium nitrate (KNO3) & calcium chloride (CaCl2.2H2O) were not optimized. After 30 days culture, we observed 83.82% hyperhydric shoots at increased level (1.5 mg/l 2iP) and 81.59% at decreased levels (1.0 mg/l 2iP). On the other hand, hyperhydricity percentage at decreased (0.4%) and at increased (0.8%) levels of agar were 72.37% and 39.08%, respectively. MS medium modification with NH4NO3 (412 mg/l), KNO3 (475 mg/l) and CaCl2.2H2O (880 mg/l) was found the best medium to reduced hyperhydricity (23.6%).

Resumo A hiperidricidade é um distúrbio fisiológico sério e afeta a propagação in vitro de muitas plantas e também da Salvia santolinifolia. O material doador para iniciar a cultura in vitro foi o calo retirado dos brotos in vitro produzidos em meio Murashig e Skoogs (MS) a 4,0 mg / l BA. Esse calo formou numerosos rebentos hiperídricos em cultura no meio da mesma composição. O objetivo foi avaliar sistematicamente o efeito das citocininas (Benziladnina (BA) e N6 - (- 2-isopentenil) adenina (2iP), magnitude dos vasos de cultura, solidificação do meio, fonte de nitrogênio e cloreto de cálcio para o alívio da hiperidricidade. culturas de tecidos de S. santolinifolia BA e 2iP induziram hiperidricidade severa, quando outros fatores, como magnitude dos vasos de cultura e uma concentração adequada de ágar, nitrato de amônio (NH4NO3), nitrato de potássio (KNO3) e cloreto de cálcio (CaCl2.2H2O), não foram otimizados. Após 30 dias de cultura, observamos 83,82% de brotos hiperídricos em níveis aumentados (1,5 mg / l 2iP) e 81,59% em níveis reduzidos (1,0 mg / l 2iP). Por outro lado, a porcentagem de hiperidricidade diminuiu (0,4%) e em níveis aumentados (0,8%) de ágar foram 72,37% e 39,08%, respectivamente. A modificação do meio MS com NH4NO3 (412 mg / l), KNO3 (475 mg / l) e CaCl2.2H2O (880 mg / l) foi encontrada melhor hiperidricidade média a reduzida (23,6%).

Occurrence of Hymenolepis diminuta: a potential helminth of zoonotic importance in murid rodents / Ocorrência de Hymenolepis diminuta: um helminto potencial de importância zoonótica em roedores murídeos

The study reveals the prevalence of a potential rodent-borne zoonotic helminth species, Hymenolepis diminuta in commensal rodents caught from irrigated and rain-fed areas of Swat, Pakistan. Three hundred and fifty rodents (269 rats and 81 mice) trapped during vegetative, flowering/fruiting and mature/harvesting stages of crops were studied from 2011-2013. Hymenolepisdiminuta eggs were identified on the basis of their shape, size, colour and markings on the surface of the egg shell and three pairs of embryonic hook-lets. Overall prevalence of H. diminuta was 3.14% (n=11/350). The highest prevalence 3.49% (n=5/143) of H. diminuta was noted at harvesting stages of the crops whereas the lowest 2.59% (n=2/77) during vegetative stage. Infection was higher in males 3.25% (n=7/215) than females 2.96% (n=4/135). Adult rodents were highly infected while no sub-adult was found infected. Infection was higher in mice 3.70% (3/81) than rats 2.69% (8/269) while no significance (p=1.0000:0.1250 to 32.00 CI). Rats and mice appears to show the most suitable reservoirs by hosting H. diminuta a zoonotic helminth. The presence of these rodents in all possible habitats can act as a main channel of transferring parasites through various habitats and can pose a hazard to humans in the area.

O estudo revela a prevalência de uma espécie potencial de helmintos zoonóticos transmitidos por roedores, Hymenolepis diminuta, em roedores comensais capturados em áreas irrigadas e alimentadas pela chuva de Swat, Paquistão. Trezentos e cinquenta roedores (269 ratos e 81 camundongos) presos durante os estágios vegetativo, floração/frutificação e maturidade/colheita das safras foram estudados de 2011-2013. Ovos de Hymenolepis diminuta foram identificados com base em sua forma, tamanho, cor e marcações na superfície da casca do ovo e três pares de anzóis embrionários. A prevalência geral de H. diminuta foi de 3,14% (n = 11/350). A maior prevalência 3,49% (n = 5/143) de H. diminuta foi observada na fase de colheita das lavouras, enquanto a menor 2,59% (n = 2/77) durante a fase vegetativa. A infecção foi maior nos homens 3,25% (n = 7/215) do que nas mulheres 2,96% (n = 4/135). Roedores adultos foram altamente infectados, enquanto nenhum subadulto foi encontrado infectado. A infecção foi maior em camundongos 3,70% (3/81) do que em ratos 2,69% (8/269), embora sem significância (p = 1,0000: 0,1250 a 32,00 CI). Ratos e camundongos parecem mostrar os reservatórios mais adequados hospedando H. diminuta um helmintos zoonótico. A presença desses roedores em todos os habitats possíveis pode atuar como um canal principal de transferência de parasitas através de vários habitats e pode representar um perigo para os humanos na área.

Occurrence of Hymenolepis diminuta: a potential helminth of zoonotic importance in murid rodents / Ocorrência de Hymenolepis diminuta: um helminto potencial de importância zoonótica em roedores murídeos

The study reveals the prevalence of a potential rodent-borne zoonotic helminth species, Hymenolepis diminuta in commensal rodents caught from irrigated and rain-fed areas of Swat, Pakistan. Three hundred and fifty rodents (269 rats and 81 mice) trapped during vegetative, flowering/fruiting and mature/harvesting stages of crops were studied from 2011-2013. Hymenolepisdiminuta eggs were identified on the basis of their shape, size, colour and markings on the surface of the egg shell and three pairs of embryonic hook-lets. Overall prevalence of H. diminuta was 3.14% (n=11/350). The highest prevalence 3.49% (n=5/143) of H. diminuta was noted at harvesting stages of the crops whereas the lowest 2.59% (n=2/77) during vegetative stage. Infection was higher in males 3.25% (n=7/215) than females 2.96% (n=4/135). Adult rodents were highly infected while no sub-adult was found infected. Infection was higher in mice 3.70% (3/81) than rats 2.69% (8/269) while no significance (p=1.0000:0.1250 to 32.00 CI). Rats and mice appears to show the most suitable reservoirs by hosting H. diminuta a zoonotic helminth. The presence of these rodents in all possible habitats can act as a main channel of transferring parasites through various habitats and can pose a hazard to humans in the area.

O estudo revela a prevalência de uma espécie potencial de helmintos zoonóticos transmitidos por roedores, Hymenolepis diminuta, em roedores comensais capturados em áreas irrigadas e alimentadas pela chuva de Swat, Paquistão. Trezentos e cinquenta roedores (269 ratos e 81 camundongos) presos durante os estágios vegetativo, floração/frutificação e maturidade/colheita das safras foram estudados de 2011-2013. Ovos de Hymenolepisdiminuta foram identificados com base em sua forma, tamanho, cor e marcações na superfície da casca do ovo e três pares de anzóis embrionários. A prevalência geral de H. diminuta foi de 3,14% (n = 11/350). A maior prevalência 3,49% (n = 5/143) de H. diminuta foi observada na fase de colheita das lavouras, enquanto a menor 2,59% (n = 2/77) durante a fase vegetativa. A infecção foi maior nos homens 3,25% (n = 7/215) do que nas mulheres 2,96% (n = 4/135). Roedores adultos foram altamente infectados, enquanto nenhum subadulto foi encontrado infectado. A infecção foi maior em camundongos 3,70% (3/81) do que em ratos 2,69% (8/269), embora sem significância (p = 1,0000: 0,1250 a 32,00 CI). Ratos e camundongos parecem mostrar os reservatórios mais adequados hospedando H. diminuta um helmintos zoonótico. A presença desses roedores em todos os habitats possíveis pode atuar como um canal principal de transferência de parasitas através de vários habitats e pode representar um perigo para os humanos na área.

Occurrence of Hymenolepis diminuta: a potential helminth of zoonotic importance in murid rodents

Abstract The study reveals the prevalence of a potential rodent-borne zoonotic helminth species, Hymenolepis diminuta in commensal rodents caught from irrigated and rain-fed areas of Swat, Pakistan. Three hundred and fifty rodents (269 rats and 81 mice) trapped during vegetative, flowering/fruiting and mature/harvesting stages of crops were studied from 2011-2013. Hymenolepisdiminuta eggs were identified on the basis of their shape, size, colour and markings on the surface of the egg shell and three pairs of embryonic hook-lets. Overall prevalence of H. diminuta was 3.14% (n=11/350). The highest prevalence 3.49% (n=5/143) of H. diminuta was noted at harvesting stages of the crops whereas the lowest 2.59% (n=2/77) during vegetative stage. Infection was higher in males 3.25% (n=7/215) than females 2.96% (n=4/135). Adult rodents were highly infected while no sub-adult was found infected. Infection was higher in mice 3.70% (3/81) than rats 2.69% (8/269) while no significance (p=1.0000:0.1250 to 32.00 CI). Rats and mice appears to show the most suitable reservoirs by hosting H. diminuta a zoonotic helminth. The presence of these rodents in all possible habitats can act as a main channel of transferring parasites through various habitats and can pose a hazard to humans in the area.

Resumo O estudo revela a prevalência de uma espécie potencial de helmintos zoonóticos transmitidos por roedores, Hymenolepis diminuta, em roedores comensais capturados em áreas irrigadas e alimentadas pela chuva de Swat, Paquistão. Trezentos e cinquenta roedores (269 ratos e 81 camundongos) presos durante os estágios vegetativo, floração/frutificação e maturidade/colheita das safras foram estudados de 2011-2013. Ovos de Hymenolepisdiminuta foram identificados com base em sua forma, tamanho, cor e marcações na superfície da casca do ovo e três pares de anzóis embrionários. A prevalência geral de H. diminuta foi de 3,14% (n = 11/350). A maior prevalência 3,49% (n = 5/143) de H. diminuta foi observada na fase de colheita das lavouras, enquanto a menor 2,59% (n = 2/77) durante a fase vegetativa. A infecção foi maior nos homens 3,25% (n = 7/215) do que nas mulheres 2,96% (n = 4/135). Roedores adultos foram altamente infectados, enquanto nenhum subadulto foi encontrado infectado. A infecção foi maior em camundongos 3,70% (3/81) do que em ratos 2,69% (8/269), embora sem significância (p = 1,0000: 0,1250 a 32,00 CI). Ratos e camundongos parecem mostrar os reservatórios mais adequados hospedando H. diminuta um helmintos zoonótico. A presença desses roedores em todos os habitats possíveis pode atuar como um canal principal de transferência de parasitas através de vários habitats e pode representar um perigo para os humanos na área.

Range of factors in the reduction of hyperhydricity associated with in vitro shoots of Salvia santolinifolia Bioss.

Hyperhydricity is a serious physiological disorder and affects In vitro propagation of many plants and as well of Salvia santolinifolia. The donor material to initiate the in vitro culture was the callus taken from the in vitro shoots produced on Murashig and Skoogs (MS) medium at 4.0 mg/l BA. This callus formed numerous hyperhydric shoots on culturing upon the medium of the same composition. The aim was to systematically evaluate the effect of cytokinins (Benzyladnine (BA) and N6-(-2-isopentenyl) adenine (2iP), culture vessels magnitude, medium solidification, source of nitrogen and calcium chloride for the alleviation of hyperhydricity. In the tissue cultures of S. santolinifolia BA and 2iP induced severe hyperhydricity, when other factors i.e. culture vessels magnitude and a suitable concentration of agar, ammonium nitrate (NH4NO3), potassium nitrate (KNO3) & calcium chloride (CaCl2.2H2O) were not optimized. After 30 days' culture, we observed 83.82% hyperhydric shoots at increased level (1.5 mg/l 2iP) and 81.59% at decreased levels (1.0 mg/l 2iP). On the other hand, hyperhydricity percentage at decreased (0.4%) and at increased (0.8%) levels of agar were 72.37% and 39.08%, respectively. MS medium modification with NH4NO3 (412 mg/l), KNO3 (475 mg/l) and CaCl2.2H2O (880 mg/l) was found the best medium to reduced hyperhydricity (23.6%).

Occurrence of Hymenolepis diminuta: a potential helminth of zoonotic importance in murid rodents.

The study reveals the prevalence of a potential rodent-borne zoonotic helminth species, Hymenolepis diminuta in commensal rodents caught from irrigated and rain-fed areas of Swat, Pakistan. Three hundred and fifty rodents (269 rats and 81 mice) trapped during vegetative, flowering/fruiting and mature/harvesting stages of crops were studied from 2011-2013. Hymenolepisdiminuta eggs were identified on the basis of their shape, size, colour and markings on the surface of the egg shell and three pairs of embryonic hook-lets. Overall prevalence of H. diminuta was 3.14% (n=11/350). The highest prevalence 3.49% (n=5/143) of H. diminuta was noted at harvesting stages of the crops whereas the lowest 2.59% (n=2/77) during vegetative stage. Infection was higher in males 3.25% (n=7/215) than females 2.96% (n=4/135). Adult rodents were highly infected while no sub-adult was found infected. Infection was higher in mice 3.70% (3/81) than rats 2.69% (8/269) while no significance (p=1.0000:0.1250 to 32.00 CI). Rats and mice appears to show the most suitable reservoirs by hosting H. diminuta a zoonotic helminth. The presence of these rodents in all possible habitats can act as a main channel of transferring parasites through various habitats and can pose a hazard to humans in the area.

Small lymphocytic lymphoma with Reed Sternberg cells: a diagnostic dilemma.

Reed Sternberg (RS) cells in the setting of small lymphocytic lymphoma (SLL) can complicate the histopathological diagnosis. We report a case of a man aged 54 years who presented with cervical lymphadenopathy. Resection of the lymph node was performed and sent for histopathological evaluation to a local laboratory. A diagnosis of SLL with Classic Hodgkin's lymphoma (CHL) was made. The medical oncologist who encountered this diagnosis for the first time sent the biopsy blocks to our laboratory for a second opinion. On review of the biopsy and immunohistochemical stains, it showed typical SLL morphology and immunophenotype. Focally, it showed large mononuclear RS type cells; however, no typical background of CHL was seen. The diagnosis was revised to 'SLL with RS like cells with no convincing evidence of CHL'. The patient was subsequently treated as a case of SLL and no progression was observed on a follow-up of 5 years.

Study of the carbonaceous aerosol and morphological analysis of fine particles along with their mixing state in Delhi, India: a case study.

Because of high emissions of anthropogenic as well as natural particles over the Indo-Gangetic Plains (IGP), it is important to study the characteristics of fine (PM2.5) and inhalable particles (PM10), including their morphology, physical and chemical characteristics, etc., in Delhi during winter 2013. The mean mass concentrations of fine (PM2.5) and inhalable (PM10) (continuous) was 117.6 ± 79.1 and 191.0 ± 127.6 µg m(-3), respectively, whereas the coarse mode (PM10-2.5) particle PM mass was 73.38 ± 28.5 µg m(-3). During the same period, offline gravimetric monitoring of PM2.5 was conducted for morphological analysis, and its concentration was ~37 % higher compared to the continuous measurement. Carbonaceous PM such as organic carbon (OC) and elemental carbon (EC) were analyzed on the collected filters, and their mean concentration was respectively 33.8 and 4.0 µg m(-3) during the daytime, while at night it was 41.2 and 10.1 µg m(-3), respectively. The average OC/EC ratio was 8.97 and 3.96 during the day and night, respectively, indicating the formation of secondary organic aerosols during daytime. Effective carbon ratio was studied to see the effect of aerosols on climate, and its mean value was 0.52 and 1.79 during night and day, indicating the dominance of absorbing and scattering types of aerosols respectively into the atmosphere over the study region. Elemental analysis of individual particles indicates that Si is the most abundant element (~37-90 %), followed by O (oxide) and Al. Circularity and aspect ratio was studied, which indicates that particles are not perfectly spherical and not elongated in any direction. Trajectory analysis indicated that in the months of February and March, air masses appear to be transported from the Middle Eastern part along with neighboring countries and over Thar Desert region, while in January it was from the northeast direction which resulted in high concentrations of fine particles.

Human papillomavirus infection in women with and without cervical cancer in Karachi, Pakistan.

BACKGROUND: No data exist on the population prevalence of, or risk factors for, human papillomavirus (HPV) infection in predominantly Muslim countries in Asia. METHODS: Cervical specimens were obtained from 899 married women aged 15-59 years from the general population of Karachi, Pakistan and from 91 locally diagnosed invasive cervical cancers (ICCs). HPV was detected using a GP5+/6+ PCR-based assay. RESULTS: The prevalence of HPV in the general population was 2.8%, with no evidence of higher HPV prevalence in young women. The positivity of HPV was associated with women's lifetime number of sexual partners, but particularly with the age difference between spouses and other husbands' characteristics, such as extramarital sexual relationships and regular absence from home. The HPV16/18 accounted for 24 and 88% of HPV-positive women in the general population and ICC, respectively. CONCLUSION: Cervical cancer prevention policies should take into account the low HPV prevalence and low acceptability of gynaecological examination in this population.

Molecular analysis of human leukocyte antigen class I and class II allele frequencies and haplotype distribution in Pakistani population.

AIM: Distribution of HLA class I and II alleles and haplotype was studied in Pakistani population and compared with the data reported for Caucasoid, Africans, Orientals and Arab populations. MATERIALS AND METHODS: HLA class I and II polymorphisms in 1000 unrelated Pakistani individuals was studied using sequence-specific primers and polymerase chain reaction and assay. RESULTS: The most frequent class I alleles observed were A*02, B*35 and CW*07, with frequencies of 19.2, 13.7 and 20%, respectively. Fifteen distinct HLA-DRB1 alleles and eight HLA-DQB1 alleles were recognized. The most frequently observed DRB1 alleles which represented more than 60% of the subjects were DRB1 *03, *07, *11 and *15. The rare DRB1 alleles detected in this study were HLADRB1 *08 and *09, having frequencies of 0.9 and 1.7%, respectively. In addition, at DRB1-DQB1 loci there were 179 different haplotypes and 285 unique genotypes and the most common haplotype was DRB1*15-DQB1*06 which represented 17% of the total DRB1-DQB1 haplotypes. In our population, haplotype A*33-B*58-Cw*03 comprised 2.8% of the total class I haplotypes observed. This haplotype was seen only in the oriental populations and has not been reported in the African or European Caucasoid. CONCLUSION: Our study showed a close similarity of HLA class I and II alleles with that of European Caucasoid and Orientals. In Pakistani population, two rare loci and three haplotypes were identified, whereas haplotypes characteristic of Caucasians, Africans and Orientals were also found, suggesting an admixture of different races due to migration to and from this region.

Diagnostic value of clot examination for malignant cells in serous effusions.

OBJECTIVE: To assess the diagnostic value of clot examination for satisfactory processing and confirmation of malignancy in serous effusions in routine cytological evaluation and compare the results with those of conventional smear and cell block preparations. METHODOLOGY: Body cavity fluids (n = 600) received in our laboratory were processed according to a pre-designed protocol for the study as follows: Day1: on receipt of the specimen, smears were made and a cell block was prepared from the sediment. Day2: after overnight sample storage of the remaining specimen at 2-8 degrees C all fluids were examined for the presence of a clot at the bottom of the container. Fluids in which clot had formed were fixed in formalin. The clot was then placed on a lens paper, wrapped and processed routinely. Diagnostic yields were compared. RESULTS: In this study, we included 600 cases of serous fluids from pleural, pericardial and peritoneal effusions. In 73% (n = 437) of samples, clot formation was seen, while in 27%, (n = 163) no clot had formed. Routine smear and cell block preparations showed malignant cells in 9.6% (n = 42). However, with the addition of the clot preparation, the number of cases in which atypical/malignant cells were seen increased from 42 to 85 (19.4%), with a P < 0.001. Special stains and immunohistochemistry (IHC) were also performed on clot preparations in 10 difficult cases. CONCLUSION: Clot preparation from body cavity fluids on the second day can be used as an adjunct to smear and routine cell block preparation to improve the accuracy and yield of the cytological diagnosis and may also be of great help for special studies such as IHC staining.

Gastrointestinal stromal tumors: a demographic, morphologic and immunohistochemical study.

BACKGROUND AND AIM: There is limited published information on gastrointestinal stromal tumors (GIST) in the South Asian region. This study was conducted to describe the demographic characteristics, organ distribution and frequency of risk categories in cases of GIST referred to a tertiary hospital. METHODS: Data pertaining to 37 cases of gastrointestinal stromal tumors received at the histopathology section of the Aga Khan University Hospital between December 2004 and July 2005 were analyzed. Immunohistochemical stains including vimentin, CD34, CD117 (c-kit), ASMA, desmin and S-100 were performed. RESULTS: Of 37 tumors, 24 (64.9%) were from males. The mean age of the patients was 50.0 years (95% CI 45.3-54.6). Tumors were categorized as high risk (27 cases; 69.2%), intermediate risk (4 cases; 10.3%) and low risk (3 cases; 7.7%). The most common site of involvement was the stomach (29.7%), followed by small bowel (24.3%), mesentery (10.8%), pancreas (8.1%), rectum (2.7%) and retroperitoneum (2.7%). In 21.6% of cases, the site of origin was not specified. The mean age at diagnosis was 50.9 years (95% CI 45.5 - 56.3) in the high risk and 44.8 years (95% CI 28.6 - 60.9) in the intermediate risk category. CONCLUSIONS: Cases of GIST referred to us were more frequently from men, most commonly from stomach or small bowel, mostly in the high risk category, and presented a decade earlier than in other reported series.

Flow cytometric and demographic analysis of t cell acute lymphoblastic leukemia in Pakistani population.

BACKGROUND: This study was carried out to analyze the proportion of T cell acute lymphoblastic leukemia (TALL) among all acute lymphoblastic leukemia (ALL) in Pakistani population and its correlation with the demographic features. Accuracy of cell surface markers used in flow cytometric analysis of the leukemic cells was also determined. METHODS: Data of 209 consecutive cases of acute lymphoblastic leukemia (ALL) presenting between July 1995 and July 2003 was analyzed. Flow cytometry was performed on all ALL cases using the standard protocols. TALL markers included CD3, CD5 and CD7. RESULTS: Proportion of TALL among known ALL Pakistani patients was 17.22%. Mean age of the TALL patients was 17.2 years. Proportion of TALL was higher in adults than in children (21.95% vs. 14.17%). Overall in this study there were more male patients affected by TALL (25/36 or 69.40%) than females (11/36 or 30.60%). The female to male ratio among TALL patients was 1:2.27. However, the proportion (%) of TALL in females was higher than males (18.96% vs. 15.82 %) i, e, 1.2:1. CD7 was found to be the most sensitive among both adults & children. It was positive in 94.4% of the TALL cases. CONCLUSION: Proportion of TALL among ALL in Pakistan is similar to that reported in this region, indicating a candidate association with geographical location and socioeconomic status. The reactivity of markers with TALL. cells was similar to what we expected based upon literature. However, due to some aberrant and cross reactivity displayed by each marker, we strongly recommend a panel approach including B and myeloid markers to ensure a correct diagnosis of TALL.

Orbital embryonal rhabdomyosarcoma in Karachi (1998-2002).

OBJECTIVE: To study the epidemiology of ocular Rhabdomyosarcoma (ORMS) in Karachi. METHODS: Incident ORMS cases resident of Karachi, registered at Karachi Cancer Registry (KCR) during 1st January 1998 to 31st December 2002 were included in the study. The data were classified using ICD-O2; computerized with Canreg-3, and analyzed using SPSS 10.0. RESULTS: Ten cases of ORMS were reported to KCR during 1998-2002. RMS originated in the orbit in eight cases, conjunctiva in one and eyelid in one. Nine cases presented with proptosis, associated with conjunctivitis in four cases. One case presented with eyelid swelling. The crude annual incidence rate was 0.13/100,000, the age standardized rate was 0.3/100,000. The mean age of childhood cases was 10.4 years (95% CI 4.0; 16.7); and adult cases was 24.8 years (95% CI 12.8; 36.7). At presentation, eight patients were older than 10 years and three were older than 20 years. Five cases were categorized as childhood malignancies. Tumors were a TNM stage III disease at presentation in eight cases; survival at the end of one year was 70%, and at the end of two years 20%. There were no survivors at the end of three years. CONCLUSION: ORMS in Karachi is a disease with a dismal survival. It may reflect a late presentation, or shorter adult ORMS survival or a manifestation of a different genetic pattern, associated with rapid evolution and poor prognosis. Health education for the population, especially parents and health providers is essential for early ORMS diagnosis. Pediatricians, ophthalmologists and health professionals, can play a vital role. Healthcare planning should focus on capacity building for ophthalmologic screening. Cytogenetic studies are advised to determine the genetic pattern.

Time-integrated thyroid dose for accidental releases from Pakistan Research Reactor-1.

The two-hourly time-integrated thyroid dose due to radio-iodines released to the atmosphere through the exhaust stack of Pakistan Research Reactor-1 (PARR-1), under accident conditions, has been calculated. A computer program, PAKRAD (which was developed under an IAEA research grant, PAK/RCA/8990), was used for the dose calculations. The sensitivity of the dose results to different exhaust flow rates and atmospheric stability classes was studied. The effect of assuming a constant activity concentration (as a function of time) within the containment air volume and an exponentially decreasing air concentration on the time-integrated dose was also studied for various flow rates (1000-50000 m3 h(-1)). The comparison indicated that the results were insensitive to the containment air exhaust rates up to or below 2000 m3 h(-1), when the prediction with the constant activity concentration assumption was compared to an exponentially decreasing activity concentration model. The results also indicated that the plume touchdown distance increases with increasing atmospheric stability.

Diagnostic surgical pathology: the importance of second opinion in a developing country.

OBJECTIVE: To review the cases sent to the section of histopathology, Aga Khan Universty (AKU) for second opinion and see whether there are significant differences in the original outside diagnosis and the subsequent diagnosis submitted by us. METHODS: A retrospective study of all consecutive cases for second opinion in the form of paraffin blocks from 1st Novemver 2001 to 31st July 2002. The primary submitted diagnosis in each case was compared with the subsequent AKU diagnosis. RESULTS: The study included a total of 381 cases. However, in 45 cases (11.81%), initial histopathological diagnosis was not provided. Out of the remaining 336 cases, there were differences between the original diagnosis and the subsequent AKU diagnosis in 120 cases (35.71%). Out of these 120 cases, immunohistochemistry was performed in 65 cases (54.16%) only. CONCLUSION: In a developing country like Pakistan, where few laboratories are equipped to function as modern histopathology units, second opinion on difficult cases is very important. Worldwide, the concept of second opinion in surgical pathology is well established.