Volume 4            Issue 3            September 2016


Role of Various Types of Viruses in Development of Early Aged Breast Cancer: A Brief Review

Bilal Arshad1, Saima Khan2, Vishnu Prasad Adhikari1, Yu Tuan Wu1, Hao Ran Chen1,

He Wu1 & Ling Quan Kong1.

  1. Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing-China.
  2. Institute of Life Sciences, Chongqing Medical University, Chongqing-China.

Corresponding Author: Bilalawan94@yahoo.com, huihuikp@163.com


World widely, Breast cancer is the most common type of cancer amongst women. External and internal factors both are responsible for beginning, advancement and development of breast cancer and from many studies it is well known that environmental elements have a significant effect in etiology of breast cancer. When it comes to environmental factors, effects of viruses are of great concern. Virus-associated cancer brings up a cancer in which the malicious conversion of the host’s diseased cells results due to any viral infection. Until now it has learned that human papillomaviruses (HPV), Epstein–Barr (EBV) and mouse mammary tumor virus (MMTV) are the prime candidate viruses that act as agents of causing breast cancer. The initiator is only one in a sequence of steps essential for malignant cells development. Breast cancer could be a hereditary disease but it is expected to account for a very small percentage of breast cancer cases. From this idea it is obvious that there should be more efforts required in evaluating the role of viruses in carcinogenesis that could be characterized by further confounding and synergistic special effects of carcinogenic aspects still exact role of viruses in tumorigenesis is unclear, but it seem like that these are responsible for causing the disease.


The Effects of Pre-Emptive Bupivacaine Infiltration of the Nephrostomy Tract in Patients Undergoing Percutaneous Nephrolithotomy: A Randomized Controlled Study

Mir Abid Jan, Sohaib Ali, Muhammad Salman Haider Qureshi  & Hamza Zaffar

Department of Surgery, Kuwait Teaching Hospital, Peshawar.

Corresponding Author: pmc.salmanqureshi@gmail.com


Background Percutaneous Nephrolithotomy (PCNL) is a surgical procedure used for the removal of renal stones. The technique is minimally invasive and is often used for the removal of renal stones that are located near the pelvis. The topical administration of local anesthetics in the surgical area has been proven effective in minimizing post-operative pain after various surgical procedures. Purpose This study was conducted to compare the mean post-operative pain score in patients with pre-operative Bupivacaine infiltration of nephrostomy tract with placebo in control group of patients undergoing percutaneous Nephrolithotomy. Methods A randomized controlled trial was carried out in Department of General Surgery, Kuwait Teaching Hospital, Peshawar with diagnosis of renal stones. A total of 66 patients (33 males and 33 females) age: 16-50 years were admitted with diagnosis of renal stones. Statistical analysis was performed by using SPSS version 17. Results Patients with renal stones who underwent PCNL were randomly divided into Group A (Bupivacaine) and Group B (Placebo). The overall Average pain score for Group A was 4.15 ± 1.48 range (2 to 7) on visual analogue scale (VAS), while that for Group B was 6.06 ± 1.02 range (4 to 8) p-value < 0.05, which indicates that preoperative infiltration of bupivacaine significantly decreases the postoperative pain in patients undergoing Percutaneous Nephrolithotomy. Conclusion The study concludes that local bupivacaine infiltration along the nephrostomy tract is an effective method of management of postoperative pain after PCNL, regardless of age and gender as shown by results of the study.


Cross-Sectional Analysis of Incidence and Extent of H.Pylori Infestation among Symptomatic

Population of Shaheed Benazirabad

Aatir H. Rajput1,2 &3, Maleeha Saleh Unar1&2 & Muhammad Muneeb1&2

  1. LUMHS Research Forum
  2. Liaquat University Hospital, Hyderabad
  3. Liaquat University of Medical & Health Sciences, Jamshoro

Corresponding Author: aatirh.rajput@gmail.com


Background H. Pylori or Helicobacter pylori is a bacterium of gram negative origin, found in the stomach and has been attributed to peptic ulcers, chronic gastritis, and cancer of the stomach (ailments that formerly were not thought to occur due to microbes) ever since it was identified nearly three decades ago. Objective: Nearly half of the global population harbors H. pylori in its upper gastrointestinal tract. However, a major proportion (i.e. eighty percent) of the victims remain asymptomatic. This research aims to determine the incidence and extent of Helicobacter Pylori infestation among symptomatic population of Shaheed Benazirabad and provide the basis for future studies investigating the extent of infestation and its relationship with symptoms. Methodology This cross-sectional analysis of incidence and extent of H. Pylori infestation was done on the basis of ELISA test results from a mainstream laboratory (Arif Diagnostics) the only laboratory, equipped with the technology to carry out this test. The data of 100 symptomatic patients visiting the laboratory in the month of June, 2014 was collected and test result was analyzed on SPSS v.16.0. Results The Mean H. Pylori levels were higher in females (12.54ug/dl) than in males (8.61ug/dl). The maximum level of infestation reported in symptomatic females (58.63ug/dl) was also considerably higher than that of symptomatic males (27.54ug/dl). H. Pylori infestation was most common (37%) among individuals aged between eighteen to twenty-eight years. Individuals aged between twenty-nine to thirty-nine years immediately followed and 30% of the symptomatic patients fell within this age bracket, majority of the sufferers were males as compared to females. Conclusion On the basis of our result, we conclude that males are more prone to suffer from symptoms even at lower levels of infestation than females and the incidence and extent of peptic ulcer infestation decreased with decreasing age in our sample.


Skeletonized Versus Pedicled Internal Mammary Harvest: Relationship of Pain Towards Technique

Ahson Memon, Ghufranullah Khan, Junaid Ansari, Khalid Rasheed & Imran Ali

Tabba Heart Institute, Karachi

Corresponding Author: ahson@aeirc-edu.com


Objective Purpose of this study is to compare skeletonized versus pedicled internal mammary harvest. Introduction One of the commonly used procedures for multi-vessel and left main coronary artery disease is Coronary Artery Bypass Grafting (CABG with fewer and recurrent complication i.e. Post procedure pain that is an outcome of mechanical, thermal or ischemic injury to the inter-costal nerves during Internal Thoracic Artery (ITA) harvesting. Methodology This study is being done to examine whether skeletonized or pedicle harvesting results in lesser occurrence and intensity of post-CABG pain with aim to identify which one is the better of the two techniques that can be used in future for patients planned with CABG. 63 consecutive patients were recruited at Tabba Heart Institute who underwent median sternotomy for CABG with Internal Thoracic Artery harvest were included. Group A went harvesting through skeletonization whereas patients in group B underwent harvesting by Pedicle ITA. This initial screening was done with the help of pre designed questionnaire. The data Statistically analyzed by SPSS. Results The results of study concluded that skeletonization of ITA does not reduce post coronary artery bypass graft surgery pain at the end of one month intervals. It is suggested that that skeletonized ITA is only beneficial when bilateral ITA are used. Conclusion It was concluded that skeletonization of ITA does not reduce post coronary artery bypass graft surgery pain at the end of one month intervals. We suggest that that skeletonized ITA is only beneficial when bilateral ITA has been used.


Prevalence and Characteristics of Stress Among Bereaved Parents After the Death of Their Under-Five Children in The Urban Slums of Karachi, Pakistan

Muhammad Bilal Siddiqui1,2, Shamoon Noushad4, Chiu Wan Ng5,

Wah Yun Low6 & Sadaf Ahmed3,4

1“Centre of Maternal and Child Health Research” (CoMCHR), AEIRC

2Hamdard University, Department of Community Health Sciences, Karachi Pakistan.

3Psychophysiology research lab, Physiology Department, University of Karachi, Pakistan.

4Advanced Educational Institute of Institute & Research Centre.

5Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia.
6Health Research Development Unit, Faculty of Medicine, University of Malaya.

Corresponding Author: drbilals@gmail.com


Introduction To understand the prevalence of stress and identifying the prevalence of different differentials of stress among bereaved parents of died under-five children is of utmost importance. This paper is based on the data from Karachi VASA under-five mortality study. The cases of this study are bereaved parents of deceased under-five children belonging to randomly selected 12 slums of Karachi city. Methodology A total of 321 parents excluded out form enrolment in VASA study were undergone stress assessment using Sadaf Stress Scale (SSS). It was found that 100% of them were truly stressed in one form or the other and the distribution is equally affecting all the slums (with slight variations). Females were found highly stressed (72%) than males (28%). The most prevalent types of stress identified were emotional (67%), traumatic (17.2%) and mental stress (7%). Out of all the stressed parents, a high proportion belongs to highest severity. The highest prevalence of the severity of traumatic stress shows that the large proportion of stressed parents have gone to Post-Traumatic Stress Disorder (PTSD), especially among mothers. Conclusion The results are quiet disturbing. The data shows that there is a high prevalence of traumatic, physical and emotional stress among bereaved parents (especially mothers) of deceased children. The prevalence of traumatic stress and its severity shows that a high proportion of stressed parents have gone to PTSD, which again have a huge impact on the overall mental health of the affected and the close family members.


Identification of Causative Organisms and Role of Ceftriaxone in Spontaneous Bacterial Peritonitis (SBP) Secondary to Decompensated Liver Disease

Anwar Ali, Zia ullah & Mahmud Majeed

Shifa International Hospital, Islamabad.

Corresponding Author: doctor_anwar786@yahoo.com


Background There is increasing trend of gram positive organism present in ascetic fluid culture as a result of selective gut decontamination of gram negative organisms by prophylactic antibiotics for SBP and due to different invasive procedures. Objectives to identify causative organisms in ascetic fluid culture of patients with spontaneous bacterial peritonitis secondary to decompensated liver disease and their sensitivities to ceftriaxone as an empiric therapy. Methods A Cross sectional study was conducted at Department of Gastroenterology, Shifa International Hospital, Islamabad. Aseptic technique was adopted to aspirate ascetic fluid. At least 10 ml of ascetic fluid was inoculated in blood culture bottle at bed side before starting ceftriaxone. Result Total 97 patients were included in this study. Among them 57 (58.8%) were male and 40 40(41.2 %) were female. The most common organism was E. coli with a frequency of 42(43.2 %) almost half were ESBL strains 20(20.6%) followed by Klebsiella 15(15.4%) among which 5(5.2%) were ESBL strains while Pseudomonas aeruginosa was 12(12.3%). Conclusion No increasing trend of gram positive pathogens was observed, however ESBL strains are emerging pathogens. Gram negative organisms are still the common pathogens of SBP.


Nutritional Stress as an Adverse Effect of

Anti-Diabetic Medications

Dur-e-shahwar1, Kisa Fatima Altaf2,3, Shamoon Noushad2 & Sadaf Ahmed1,2

  1. Psychophysiology Research lab, Physiology Dept, University of Karachi.
  2. Advance Educational Institute and Research Centre
  3. Dadabhoy Institute of Higher Education

Corresponding Author: Kisa@aeirc-edu.com


Objective To estimate the intensity of nutritional stress among the diabetic patients. Background Non-Communicable diseases (NCDs) are the leading cause of morbidity and mortality in Pakistan. The WHO report evaluated diabetes at the fourth position among the four types of NCD’s, this accounts for 1.5 million deaths annually. Introduction Nutritional stress depends on what we give to our body, whether it is toxin loaded, chemically constituted platefuls of food and expect it to cope without a grumble. As, diabetes is metabolic syndrome so there is an altered carbohydrate and fat metabolism in these patients that will lead to the development of nutritional stress in these patients. Methodology A cross sectional survey based study was conducted at a local hospital including diabetic patients on anti-diabetic medicines.  Demographic data, medical history and drug use duration and dosage were investigated as well as intensity of nutritional stress was calculated by Sadaf stress scale (SSS). The patients with severe and psychological and mental illness or any other chronic illness or patients who were failed to provide reliable information were excluded from study. Result The total of 42 patients have participated in the study out of that 50% have reported mild nutritional stress and 36% have reported moderate nutritional stress. The most common reported symptom of nutritional stress includes sleep problem, abdominal bloating, incomplete emptying and sugars and carb craving. Conclusion The patients have reported the nutritional stress due to the altered carbohydrate and fat metabolism and the use of anti-diabetic medicine further increases the intensity of nutritional stress. The symptoms that are reported in diabetic patients are not associated with diabetes instead occur as a result of anti-diabetic medication use. Such as, sleep problem usually associated with increased stress, increased blood pressure, impaired control of blood glucose, and increased inflammation.


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