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Karachi, Pakistan

Memon M.A.,Atomic Energy Medical Center | Rashid A.,Neurospinal Medical Institute | Khan A.,North West Armed Forces Hospital | Asghar A.S.,North West Armed Forces Hospital
Journal of the College of Physicians and Surgeons Pakistan

We present a case of follicular dendritic cell sarcoma in a 48 years old Saudi female who reported with slowly progressive right sided extranodal neck mass associated with pulmonary metastasis. Clinical examination, histopathologic features including distinct immunostains combine together to make the rare diagnosis of follicular dendritic cell sarcoma. This entity is often misdiagnosed due to non-consideration in differential diagnosis of sarcoma. It carries a significant potential for regional as well as distant spread and hence categorized as intermediate risk malignancy. Clinical, histopathological and immunohistochemical aspects and therapeutic options of this unusual case are discussed. Source

Bhutto S.A.,BMSI | Shoro A.A.,LMC | Makhija P.M.,Medical Unit 2 | Arif M.,Atomic Energy Medical Center | And 2 more authors.
Medical Forum Monthly

Objective: The purpose of this study was to judge the ability of L-arginine to restore the carbohydrate, protein and fat metabolism particularly in the liver against lithium carbonate induced hepatotoxicity. Study Design: This study is randomized, interventional, prospective, morphometric and Histochemical study. Place and Duration of Study: This study was conducted in the department of anatomy, BMSI, JPMC, Karachi. Animals were obtained from the animal house of BMSI, JPMC, Karachi. The duration of this study comprises of two, six and twelve weeks. Materials and Methods: Sixty albino adult rats 90 - 120 days of age weighing about 200 - 300 grams were used for this study. Animals were divided into four different groups each comprising 15 rats. Each major group was subdivided into three sub-groups 1, 2 & 3 on the basis of 02 weeks, 6 weeks and 12 weeks duration of treatment respectively. 4 urn thick sections of rat liver were stained with PAS haematoxylin, Gomori's calcium phosphate and oil red O. Serum analysis of ALT and ALP was done. Results: Lithium treated group on PAS staining displayed depletion of glycogen content of hepatocytes. Gomori's calcium phosphate staining revealed diminution of the intracellular enzyme contents of hepatocytes especially alkaline phosphatase (ALP) and concomitant rise in serum hepatic enzymes like Alanine aminotransferase (ALT) and ALP. Oil red O stained sections of the liver depicted microvesicular fatty infiltration in liver cells in lithium treated group B animals. Conclusion: This study revealed that the toxicity of lithium is manifested histochemically by disturbances of in the glycogen, lipid and enzyme metabolism in the liver simultaneously exhibiting the restoration of the same metabolism by L-arginine as a best adjuvant in the treatment of bipolar disorder with lithium carbonate. Source

Fatima N.,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN | Niaz K.,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN | Maseeh-Uz-Zaman,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN | Kamal S.,Atomic Energy Medical Center | Hameed A.,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN
Journal of the College of Physicians and Surgeons Pakistan

Objective: To assess early nephrotoxicity of CDDP (Cis- diamminedichloroplatinum) manifested by a decline in the glomerular filtration rate (GFR) estimated by plasma two sample clearance method (PSC 2) after 99mTc-DTPA injection. Study Design: Descriptive study. Place and Duration of Study: Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, from September 2004 to January 2005. Methodology: The renal function was assessed on 36 patients suffering from different types of cancer and receiving CDDP in doses of ≥50 mg/m2 before and after in each of six CDDP cycles. The GFR was determined by PSC 2 method after 99mTc-DTPA injection). A paired sample t-test was used for comparision of the mean value with significance at p < 0.01. Results: There were (28 males and 8 females; age range being 16-68 years) The average decline in GFR baseline to the end of sixth cycles was 43.86 ml/min/1.73m 2 (p=0.000) as estimated by PSC 2 method. There was a significant fall of average 9.36 ml/min/1.73m2 (p < 0.01) in GFR as observed in each cycle of CDDP estimated by the PSC 2 method. In the initial four cycles, CDDP produced a major nephrotoxic effect of average 10.27 ml/min/1.73m 2 (p < 0.01) fall in GFR. This then gradually declined to a plateau of an average decline in GFR of 7.76 and 7.31 ml/min/1.73m2 (p=0.000) after the 5th and 6th cycle respectively. Conclusion: CDDP produced an early nephrotoxicity which was manifested by a significant decline in GFR in each cycle. Tc-99m PSC 2 method for GFR estimation should be used periodically for the early detection of nephrotoxicity induced by CDDP. Source

Kron T.,RMIT University | Azhari H.A.,Gono University | Voon E.O.,Radiation Safety and Quality Unit | Cheung K.Y.,Prince of Wales Hospital | And 18 more authors.
Biomedical Imaging and Intervention Journal

Background: Medical physicists are essential members of the radiation oncology team. Given the increasing complexity of radiotherapy delivery, it is important to ensure adequate training and staffing. The aim of the present study was to update a similar survey from 2008 and assess the situation of medical physicists in the large and diverse Asia Pacific region. Methods: Between March and July 2011, a survey on profession and practice of radiation oncology medical physicists (ROMPs) in the Asia Pacific region was performed. The survey was sent to senior physicists in 22 countries. Replies were received from countries that collectively represent more than half of the world's population. The survey questions explored five areas: education, staffing, work patterns including research and teaching, resources available, and job satisfaction. Results and discussion: Compared to a data from a similar survey conducted three years ago, the number of medical physicists in participating countries increased by 29% on average. This increase is similar to the increase in the number of linear accelerators, showing that previously identified staff shortages have yet to be substantially addressed. This is also highlighted by the fact that most ROMPs are expected to work overtime often and without adequate compensation. While job satisfaction has stayed similar compared to the previous survey, expectations for education and training have increased somewhat. This is in line with a trend towards certification of ROMPs. Conclusion: As organisations such as the International Labour Organization (ILO) start to recognise medical physics as a profession, it is evident that despite some encouraging signs there is still a lot of work required towards establishing an adequately trained and resourced medical physics workforce in the Asia Pacific region. © 2012 Biomedical Imaging and Intervention Journal. Source

Kron T.,Peter MacCallum Cancer Cancer Institute | Kron T.,RMIT University | Azhari H.A.,Gono University | Voon E.O.,Radiation Safety and Quality Unit | And 19 more authors.
Australasian Physical and Engineering Sciences in Medicine

It was the aim of this work to assess and track the workload, working conditions and professional recognition of radiation oncology medical physicists (ROMPs) in the Asia Pacific region over time. In this third survey since 2008, a structured questionnaire was mailed in 2014 to 22 senior medical physicists representing 23 countries. As in previous surveys the questionnaire covered seven themes: 1 education, training and professional certification, 2 staffing, 3 typical tasks, 4 professional organisations, 5 resources, 6 research and teaching, and 7 job satisfaction. The response rate of 100 % is a result of performing a survey through a network, which allows easy follow-up. The replies cover 4841 ROMPs in 23 countries. Compared to 2008, the number of medical physicists in many countries has doubled. However, the number of experienced ROMPs compared to the overall workforce is still small, especially in low and middle income countries. The increase in staff is matched by a similar increase in the number of treatment units over the years. Furthermore, the number of countries using complex techniques (IMRT, IGRT) or installing high end equipment (tomotherapy, robotic linear accelerators) is increasing. Overall, ROMPs still feel generally overworked and the professional recognition, while varying widely, appears to be improving only slightly. Radiation oncology medical physics practice has not changed significantly over the last 6 years in the Asia Pacific Region even if the number of physicists and the number and complexity of treatment techniques and technologies have increased dramatically. © 2015, Australasian College of Physical Scientists and Engineers in Medicine. Source

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