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Marri M.Z.,Liaquat National Medical College | Bashir M.Z.,Aga Khan University
Journal of the College of Physicians and Surgeons Pakistan | Year: 2010

Objective: To determine the pattern of homicidal deaths caused by rifled weapons in Peshawar as regards the parameters of age, gender, place of occurrence and the number and location of injuries on the body. Study Design: Descriptive study. Place and Duration of Study: The study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar, from June 2005 to February 2006. Methodology: The subjects were selected from victims presenting for autopsy at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar. One hundred cases were selected where the weapon of offence was a rifled weapon and the manner of death was homicide on the basis of the police inquest, the autopsy and an interview with the relatives of the victim. After the autopsy, the findings were tabulated and analyzed. Results: Homicides predominantly occurred in young males residing in a rural locality. The peak incidence was between 20-29 years in males and in females the age group most prone was 30-39 years. Male to female ratio was 6:1. The chest (33.8%) followed by the head and abdomen were the areas primarily targeted. Conclusion: High velocity automatic weapons are primarily being used to kill young people in rural areas. Prevention can be through strict gun control laws coupled with education and awareness. Source

Zeeshan R.,Liaquat National Hospital | Irfan S.M.,Liaquat National Hospital | Sultan S.,Liaquat National Hospital | Bhimani S.,Liaquat National Medical College
Asian Pacific Journal of Cancer Prevention | Year: 2015

Background: Chronic lymphoid leukemia (CLL) is the most frequent type of adult leukemia. The Rai and Binet staging systems have been well recognized as standards for assessing the treatment requirements and overall survival in CLL patients. However, there is a need to seek newer prognostic markers to identify stable or progressive forms of CLL that will facilitate risk-adapted treatment strategies. Currently a molecular biomarker ZAP-70 has attracted interest as providing prognostic information in CLL patients. Objective: To determine the frequency of ZAP-70 positivity in B-CLL patients at disease presentation. Materials and Methods: From January 2011 to September 2014, 89 patients were diagnosed to have chronic lymphoid leukemia. Complete blood count was done on an automated analyzer (Cell Dyne, Abott Architect, USA), while immunophenotyping was conducted for each patient to establish the diagnosis of the disease. ZAP-70 expression was evaluated by flow cytometry. Data were compiled and analyzed by SPSS version 21. Results: Out of the total of 89 B-CLL patients, 62 (69.7%) were male and 27 (30.3%) were females with a male to female ratio of 2:1. The mean age was 57.5±12.1 years. The frequency of ZAP-70 positivity in our B-CLL patients was found to be 13.5%. ZAP-70 positivity was significantly correlated with stage III disease and high absolute lymphocytic count (P < 0.05). No correlation of ZAP-70 could be established with age and gender (p > 0.05). Conclusions: The frequency of ZAP-70 in our patients appears low. It is approximately half that in international data. We would recommend to screen all the newly diagnosed patients with CLL for ZAP-70 protein expression for risk stratification, family counseling and to predict overall survival. Source

Sultan S.,Liaquat national hospital and medical college | Irfan S.M.,Liaquat national hospital and medical college | Khan S.R.,Liaquat National Medical College
Asian Pacific Journal of Cancer Prevention | Year: 2016

Background: Polycythemia rubra vera (PV), being a primary polycythemia, is caused by neoplastic proliferation of erythroid, megakaryocytic and granulocytic lineages which result in panmyelosis. PV patients have a somatic acquired mutation in the Janus kinase (JAK2) pathway, rendering cell proliferation independent of the normal regulatory mechanisms that regulate erythropoiesis. The rational of this study was to determine the prevalence of the JAK-2 V617F mutation in Pakistani patients with PV. Materials and Methods: In this cross sectional study, 26 patients with PV were enrolled from January 2010 to December 2014. Patients were diagnosed based on WHO criteria for PV. All were screened for G-T point mutation (V617F) in the JAK2 gene on chromosome 9 by an allele specific PCR. Results: The mean age was 53.4±9.31 years (range 36-72) and the male to female ratio was 2:1. The frequency of JAK2 V617F positivity in our PV patients was found to be 92.3%. Overall 30.7% of patients were asymptomatic and remaining 69.3% presented with symptomatic disease. The mean hemoglobin was 18.1±1.9g/dl with the mean hematocrit of 55.6±8.3%. The mean total leukocyte count was 12.8±7.1x109/l and the platelet count was 511±341.9x109/l. A positive correlation of JAK2 V617F mutation was established with high TLC count (P=0.01). No correlation of JAK2 V617F could be established with age or gender (P > 0.05). Conclusions: The JAK2 V617F mutation frequency in our PV patients was similar to those reported internationally. Screening for the mutation in all suspected PV cases could be beneficial in differentiating patients with reactive and clonal erythrocytosis. Source

Sultan S.,Liaquat national hospital and medical college | Irfan S.M.,Liaquat national hospital and medical college | Jawed S.N.,Liaquat National Medical College
Asian Pacific Journal of Cancer Prevention | Year: 2016

Background: Myelodysplastic syndrome (MDS) is a clonal disorder of hemopoeitic stem cells, characterized by infective hematopoiesis, peripheral cytopenias along with hypercellularity of marrow and marked dysplastic features. Our aim was to study the spectrum of the WHO classification in adult Pakistani patients with MDS at disease presentation. Materials and Methods: This retrospective descriptive study was conducted at Liaquat National Hospital and Medical College, extending from January 2010 to December 2014. Patient data were retrieved from the maintained archives. Results: Overall, 45 patients were diagnosed at our institution with de novo MDS during the study period. There were 28 males and 17 females. Age ranged between 18 and 95 years with a mean of 57.6±17.4 years. The male to female ratio was 1.7:1. According to the WHO classification, 53.3% had refractory cytopenia with multilineage dysplasia, 22.2% had refractory cytopenia with unilineage dysplasia, 4.4% each had refractory anemia with excess of blasts-1 and II and 15.5% had MDS unclassified. The main presenting complaints were generalized fatigue (60%), fever (33.3%), dyspnea (15.5%), bleeding (13.3%) and weight loss (11.1%). Physical examination revealed pallor in 37.7%, followed by petechial and purpuric rashes in 20% of patients. Hemoglobin was < 10 g/dl in 41 (91.1%). Pancytopenia and bicytopenia were noted in 18 (40%) and 14 (31.1%) respectively. Conclusions: MDS in our patients presents at a relatively young age. Refractory c ytopenia with multilineage dysplasia was the dominant disease variant in our setting. Source

Mahar Y.,Basic Medical science Institute | Shoro A.A.,Liaquat National Medical College | Naqvi A.,BMSI
Pakistan Journal of Medical and Health Sciences | Year: 2012

Aims: To evaluate the protective role of L-arginine (L-arg) on the morphology of adrenal cortex of streptozotocin (STZ) treated adrenal glands of albino rats. Serum adrenocorticotropin (ACTH) and corticosterone levels were also determined as stress markers. Study design: Prospective experimental study. Place and duration of study: This study was conducted in the Department of Anatomy Basic Medical Sciences Institute (BMSI), JPMC, Karachi, from February to March, 2011. Material & methods: In a 6 weeks study, 30 male albino rats were divided into 3 groups, containing 10 animals each. Gp-A was treated as control. Gps-B received STZ 37mg/kg intraperitoneally (I/P) only once at the start of experiment. Gps-C received L-arg orally in a dose of 0.3 mg/100GB.W/day a week before STZ treatment.Serum ACTH and corticosterone levels were also measured. Results: Haematoxylin and Eosin (H&E) stained sections of cortex of adrenal glands of STZ treated Gp-B showed marked pathology and dis-arrangement of cells in all the three zones of adrenal cortex. Atrophy of zona glomerulosa (Z.G.) and hypertrophy of zona fasciculata (Z.F.) was observed in Gp-B along with enhanced secretions of serum ACTH and cortisol. L-arg had moderately reduced the severity of damage to the adrenal cortex in Gps-C there was also a moderate increase observed in the serum levels of ACTH and decreased corticosterone. Conclusions: L-arg as a nitric oxide (NO) donor and as an antioxidant, plays a significant role in preserving adrenal morphology and functions in cancer patients who are treated with chemotherapeutic drugs like STZ. Source

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