Year 2019, Volume 35 - Issue 2

Cancer is one of the major causes of morbidity and mortality to human population that leads to almost 7.6 million deaths per year globally. Invasion and migration are the main characteristics in the all types of cancers. To combat this deadly disease, prophylaxis, quick diagnosis, researching novel molecular adjuvant therapeutics or the combination of all these strategies are strictly required. Fascin, a 55 kD globular protein is expressed in the metastatic tumors and not in the normal cells. Up-regulation of Fascin has been reported in more aggressive and advanced stage of metastatic cancers. It is an indicator of poor prognosis and late stage of carcinoma. Fascin has two important actin binding sites that help in the invasion and metastasis. New molecular research is focused to inhibit its binding activity by knockdown of Fascin using short hairpin RNA (shRNA), ectopic expression of microRNAs (miRNAs), small interfering RNA (siRNA), using small fascin inhibitors, monoubiquitination and use of antimicrobial peptides. Meta-analysis and systematic review will help a lot to develop new therapeutic strategies that can inhibit tumor cell invasion and even metastatic spread of various carcinomas

Background and Objective: Neck swellings are very common conditions which can be diagnosed in a short time by doing fine needle aspiration cytology (FNAC). It is used to diagnose different inflammatory and neoplastic conditions of lymph nodes, thyroid, salivary glands and soft tissues. Moreover, it is cost effective and has no or minimal side effects.
Methods: A total of 100 patients with nock swellings were included. A prospective study was conducted from January, 2018 to May, 2019. Cytological diagnosis was made and correlated clinically. Data analysis was done by Statistical Package for the Social Sciences (SPSS) Version 20 and expressed as frequency and percentage.
Results: Among hundred FNAC procedures were performed, of which majority (95%) were benign, and a few (5%) were malignant. Out of total 60 Lymph node lesions, chronic granulomatous inflammation, was the most common (53.33%). There were two cases of Non-Hodgkin’s Lymphoma and one of meta-static carcinoma in lymph node. In all 30 cases of thyroid lesions, frequency of benign follicular lesions (Bethesda II) was 86.66%. Pleomorphic adenoma (50%) was the commonest amongst salivary gland lesions.
Conclusion: Fine needle aspiration cytology is a simple and effective method of assessing neck lumps. FNAC can differentiate infective and benign conditions from malignant ones and helps in speedy and safe diagnosis of patients with optimal guidance for further excision.

Background and Objective: Hepatitis E viral infection is one of the major health concerns in the pregnant women owing to its fulminant nature in pregnancy and contribution to increase the mortality in pregnant women as compared to non-pregnant females. So, this study was conducted with an objective to find out the pregnancy related mortality, maternal morbidity and fetal outcome suffering with hepatitis E (HEV) in pregnancy.
Methods: This study was conducted in Hussain Memorial Hospital Lahore and Sir Ganga Ram Hospital, Lahore for the period of one year and seven months between May 2017 and November 2018. This cross sectional study recruited 60 females with serologically proven HEV in pregnancy. All of these targeted patients were admitted in the aforesaid hospital and followed with coagulation profile and liver function test. The record of maternal mortality, morbidity and fetal outcome was duly maintained.
Results: More maternal morbidity was noted in patients who were admitted in the third trimester with clinical disease and based on laboratory results i.e. the derangement of haematological and biochemical tests. Of the 60 targeted patients, majority of the patients (73.33%) were discharged home safely, therefore, remaining patients were expired with the overall mortality rate of 26.67%. Moreover, perinatal mortality rate was recorded as 30.3 per 1000 live birth.
Conclusion: In conclusion, Hepatitis E is a serious issue in underdeveloped and developing countries with high maternal morbidity and mortality rates in pregnancy especially last trimester. It also increases the risk of perinatal mortality, morbidity and preterm delivery.

Background and Objective: The congenital absence of one or more deciduous or permanent teeth is called hypodontia. It is the most common congenital dental anomaly. Hypodontia could be caused by a number of genetic and environmental factors. The aim of the current study was to find out the impact of hypodontia on the emotional well-being and quality of life of children.
Methods: A cross sectional comparative study was carried outon 40 patients suffering from hypodontia and 40 healthy controls in the outpatient department of Nishtar Institute of Dentistry, Multan. Patients and healthy controls were selected by non-probability convenient sampling technique without any gender discrimination. Age of the selected patients and controls was 11-14 years. Oral health was checked by using dental examination instruments. Urdu translated proformas were used for better understanding of children.
Results: Mean age of the patients suffering from hypodontia was 11.8 (± 0.90) years and mean age of healthy controls was 11.9 (± 0.98). Family history was positive in 6 (15%) patients suffering from hypodontia and 2 (5%) in healthy controls. Out of 40 patients, about 80% felt irritated, 82.5% felt shy, 82.5% children were worried that what other people think about them, 85% were worried that they were not good looking and 80% were upset.
Conclusion: Hypodontia has substantial impact on the emotional well-being and quality of life of the children. Patients were emotionally disturbed and had a poor quality of life.

Background and Objective: β-thalassemia is inherited blood disorder which affects the metabolism of whole body including bones. Absence of globin chain leads to anemia which results in high serum ferritin levels. It affects the levels of serum leptin. This study is designed to evaluate serum leptin and its correlation with bone density in healthy and β-thalassemia children.
Methods: It is a comparative cross-sectional study which includes 65 normal and 65 β-thalassemia major children. Their demographic data was recorded. All children were examined for bone status with the help of Quantitative Ultrasound Bone Profiler. Z-score, Speed of Sound (Ad-SOS) and transmission time through bone (BTT) were recorded. Plasma sample was collected to determine serum Leptin level by Enzyme Immunosorbent Assay (ELISA) method.
Results: In normal children mean AD-SOS was 1906.86 ± 49.53 m/sec and of β-thalassemia major children was 1893.62 ± 57.88 m/sec. The mean serum Leptin of normal children was 3.12 ± 2.84 ng/ml and of β-thalassemia children was 1.38 ± 1.17 ng/ml.
Conclusion: Bone density is reduced in β-thalassemia children in contrast to healthy children. Serum Leptin is significantly decreased in β-thalassemia major children than in healthy controls. Positive correlation of serum leptin with bone profile was observed, though not statistically significant, which indicates that leptin deficiency is a cofactor leading to decline in bone density at early age.

Background and Objective: Obesity is a rapidly growing morbidity, putting lives of the affected individuals at risk and badly affecting the quality of their life. Garcinia Cambogia is claimed to be the most effective natural ingredient present in these slimming agents. This study was designed to investigate the effects of the Garcinia Cambogia on liver histology.
Methods: Ninety male albino mice were randomly divided into three groups containing thirty mice each. Group I served as Control group and group II and III were experimental groups administered with drugs A (Slim Smart) and B (Ultra Slim Plus) respectively via oral gavage, whereas control group was only given equivalent volume of distilled water. Animals were sacrificed and liver were inspected for congestion and lymphocytic infiltration on histological examination.
Results: Histological examination revealed that group II and III had significantly larger number of inflammatory cells/HPF as compared to group I (P-value = 0.001). Group II and III were having no significant differences when compared for inflammatory cells (P-value = 0.172).Features of congestion were present in 60 (100%) animals of group II and III when compared to group I (P-value = 0.001).
Conclusion: Garcinia Cambogia containing weight reducing drugs tested in this experiment adversely affected the histology of liver. Both Slim Smart and Ultra Slim Plus have hepatotoxic effects resulting in marked cellular infiltration and congestion.

Background and Objectives: Immunocompromised state developing due to irreversible renal compromise promotes Hepatitis B and C seropositivity in haemodialysis patients. Direct contact and contamination of machines are the main source. The present study was designed to assess the seropositivity of Hepatitis B and C in haemodialysis patients in Tertiary care hospitals of Lahore. The secondary aim was to assess the perception of haemodialysis patients regarding Hepatitis B and C.
Methods: Cross sectional study was conducted on 78 haemodialysis patients of Fatima Memorial and Sheikh Zayed Hospital within four months. Seropositivity and perception regarding Hepatitis B and C was assessed using a structured questionnaire by interviewing after fulfilling ethical considerations. SPSS was used to analyze the data.
Results: Out of 78 patients, 47 (60.3%) were male and 31 (29.7%) patients were female. Awareness amongst haemodialysis patients was mediocre, 40 (51.2%). Seropositivity for Hepatitis B and C was 45 (57.6%) with 12 (26.7%) being declared as Hepatitis B and C positive during dialysis. Active screening was being done for haemodialysis patients, 70 (89.7%) with 45 (57.6%) being vaccinated for Hepatitis B. Patients 69 (88.4%) thought cleanliness and hygiene were best control measures to avoid the spread of Hepatitis B and C, contrary to 31 (39.7%) believing in spread through contamination of blood. Testing for Hepatitis B and C was more in public sector (x 2 4.62, P-value 0.03). A significant difference between public and private sector patients with opinions that these diseases could be prevented in dialysis clinic (x 2 6.48, P-value 0.01) by applying preventive measures was recorded.
Conclusion: Majority haemodialysis patients are seropositive for Hepatitis B and C. Perception of patients regarding mode of transmission, safety measures, and hazards of dialysis was average. Health education and routine disinfection can be considered to be the major measures to be adopted for reduction of spread of Hepatitis B and C.

Background and Objective: Newborns from diabetic mothers, including diabetes type 1 & 2 and gestational diabetes, represent the group with the highest risk of developing symptomatic hypoglycemia in the immediate hours after birth. Neonatal hypoglycemia is a common metabolic abnormality in newborns due to inability to maintain glucose homeostasis. This study was designed to determine the glycemic levels in infants born to diabetic mothers at 2 hours of life before first feeding.
Methods: A total of 203 cases meeting inclusion criteria were recruitedfrom Nursery department of a local hospital of Lahore. After obtaining prior informed consent from parents or attendants, birth history like gestational age and their birth weight were noted from birth records of the baby. Blood sugar random (BSR) was measured in all neonates as per recommended criteria. All data was entered
and analyzed using SPSS version 20.
Results: The mean age of neonates at the time of blood sugar monitoring was 68.86 ± 34.39 minutes, the mean gestational age was 38.25 ± 2.901 weeks and the mean birth weight was 2844.3 ± 605.0677 gm. According to operational definition, a total of 30 (14.8%) cases had hypoglycemia and 173 (85.2%) cases had normal BSR.
Conclusion: Hypoglycemia in neonates of diabetic mothers is a common complication which may be corrected by early breast-feeding or formula feeding.

Background and Objectives: Globally, 1.1 billion people use tobacco for smoking and the use of nonsmokable tobacco products have also been increased over the couple of decades. This study was to assess the oral hygiene practices and choices of oral hygiene products among smokers and beetle nut chewers. This study also compares the oral hygiene practices among them.
Methods: A purposive sample of 389 subjects was recruited for this comparative cross-sectional study. Self-administered questionnaire including sociodemographic information, tobacco consumption, choice of oral hygiene practices and oral hygiene products was used. Descriptive statistics were calculated for comparison between non-smokers and smokers in terms of sociodemographic awareness regarding impact of smoking on oral health and Chi-square test was used to observe to compare oral hygiene practices among smokers, betel leaf chewers.
Results: The participants were consuming tobacco on daily basis and the unit consumption per day (Mean = 4.7, SD = 2.2) was also significantly high. Time spent on cleansing of teeth was sufficient (Mean = 1.5, SD = 0.7) but the brushing teeth at least two times a day was the only oral hygiene practice followed by meager (42.9%) but highest in number among the study participants. Use of oral hygiene products including toothbrush, miswak, dental floss and mouth wash were popular among the people. Oral hygiene practices were significantly different (P< 0.05) among smokers, betel leaf consumers.
Conclusion: Study concludes that oral hygiene practices among smokers are better than those who are betel leaf chewers. Moreover, most common use of oral hygiene products among people includes tooth-brush, miswak, dental floss and mouth wash

Background and Objectives: Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality. It affects the multiple organ systems of the maternal body and may also cause preterm labour, small for gestational age infants, low birth weight, retardation and fetal growth restriction. So, the objective is to determine the level of inflammatory marker i.e. C-reactive proteins in pre-eclamptic and normotensive pregnant women and to find out its correlations with foetal birth weight.
Methods: Analytical study was conducted in the different units of Obstetrics & Gynaecology, Sir Ganga Ram Hospital, Hussain Memorial Hospital and Surraya Azeem Hospital, Lahore from February 2018 to March 2019. The study included 59 cases with preeclampsia and 59 normotensive pregnant women, all in their 3rd trimester. All the females were in the age group of 20-40 years and had a BMI range of 18-25. High sensitive C-reactive protein (hsCRP) levels were measured by Enzyme Link Immunosorbant Assay (ELISA). Statistical analysis was done using SPSS (version 15). The values were significant at the 0.05 level of significance.
Results: C-reactive protein levels were significantly high (P<0.001) in the pre-eclamptic group with a median value of 8.8 (0.3 to 24.5) as compared to 5.4 (0.24 to 9.8) mg/l in the normotensive women. The birth weight of babies was low in the pre-eclamptic group. The high CRP levels were negatively correlated with foetal birth weight in the pre-eclamptic group.
Conclusion: Elevated C-reactive protein level in pregnant women is part of an increased maternal systemic inflammatory response and correlates with low foetal birth weight.