Calcifying fibrous pseudotumour of maxilla: A rare entity mimicking malignancy: A case report

Occurrence of inflammatory pseudotumour in head and neck region or nose and paranasal sinuses is rare. However, when they do occur, they could be quite aggressive. Etiologically, they are believed to be reactive than neoplastic, and calcification may suggest end-stage. Their clinical presentation and radiologic features may resemble a malignancy. Grossly, they are not encapsulated, but multilobulated and can be circumscribed or infiltrative. Histologically, they constitute of bland spindle cells with scant cytoplasm and occasional mitotic figures. Scattered lymphocytic and plasma cell infiltrates with abundant dense hyalinized collagenous stroma and focal small calcifications are seen. Presence of atypia, DNA aneuploidy, and abnormal p53 expression may suggest malignant potential. Though not known to metastasize, they can lead to local complications, causing destruction of bone and surrounding tissues. Management is mainly by surgical excision though adjunct corticosteroids have been advocated. We report such a rare case of calcifying fibrous pseudotumour of maxilla

Atrial Fibrillation and its Association with First Ever Stroke

Objective: To determine the frequency of atrial fibrillation in adult patients with first ever ischaemic stroke. Methodology: A total of 86 patients of stroke were selected for this study. CT scan brain (plain) was advised for all the patients. Subsequently those patients in whom CT scan was suggestive of ischemic stroke, a 12 leads electrocardiogram was done for the confirmation of atrial fibrillation, which was verified by a cardiologist. Results: The mean age of the patients was 57.16+17.12 years. There were 52 (60.5%) male and 34 (39.5%) female patients. Out of total 86 patients, pulsus deficit was present in 17(19.8%) patients. The mean ventricular rate was 86.98 + 22.13 per minute. There were 17 (19.8%) patients with irregular rhythm recorded on ECG while 69 (80.2%) patients had regular rhythm. Likewise P wave was absent in 17(19.8%) patients and present in the remaining 69 patients (80.2%).There were 17 (19.8%) patients in whom atrial fibrillation was present while in  69 (80.2%) patients it was absent. Conclusion: Atrial fibrillation is a common arrhythmia and a major risk factor for ischemic stroke, especially in the elderly. The prevalence of atrial fibrillation in ischemic stroke increases with age in both genders

Učinak hranidbe usitnjenim sjemenkama uzgojene crnjike Nigella sativa L. na proizvodnju jaja i njihovu neškodljivost za ljudsku upotrebu.

The effect of Kalongi (Nigella sativa, L.) seeds was studied on the performance of layers and cholesterol contents of their egg-yolks. A total of 96 White-Leghorn birds of 40 weeks of age and at the egg laying stage were randomly divided into 12 experimental units, eight birds in each unit. These units were randomly allotted to four treatments in such a way that each treatment received 3 experimental units. Four test rations were prepared by supplementing a commercial layer-ration with powdered Kalongi seeds at the rates of 0.0, 0.5, 1.0 and 1.5%. Effects of feeding these rations on feed intake, egg production, egg mass, egg shell thickness, Haugh unit, yolk index, blood spots, meat spots and total cholesterol in eggs were determined after a period of 12 weeks. Blood samples of the two birds selected at random from each replicate were taken at 0, 6 and 12 weeks. The serum obtained from these samples was analyzed for total cholesterol, low-density lipoproteins, high-density lipoproteins and triglycerides. Data on feed intake, feed refused and egg production were used to calculate the feed conversion ratio. Results showed that Nigella sativa seeds significantly (P0.05) change in yolk index, blood and meat spots. The Nigella sativa seeds also significantly (P0,05) u odnosu na indeks žumanjka te prisutnost krvnih i mesnih mrlja. U jaja nesilica hranjenih usitnjenim sjemenkama crnjike zabilježena je značajno manja količina (P<0,05) kolesterola. Ustanovljene su i niže razine serumskih triglicerida, lipoproteina niske gustoće i ukupnog kolesterola, dok je razina loipoproteina visoke gustoće bila povišena dodavanjem komercijalne hrane sa sjemenkama crnjike

Three pregnancies with mechanical heart valve and no follow-up in 10 years

Anticoagulation and proper INR (International Normalized Ratio) monitoring is essential for patients having mechanical heart valves; it is vital in these patients in order to prevent lethal complications such as valve thrombosis and systemic embolism. In pregnancy, it becomes even more important as pregnancy itself is a hypercoagulable state. This report describes a female patient having undergone mitral valve replacement with a Starr Edward metallic prosthesis. She came back to the operating surgeon after 10 years of valve replacement with a history of three uneventful healthy deliveries and no follow-up and INR monitoring during this period

A Descriptive Study: Integration of Technology Bring Flexibility to Distance Education in Pakistan

Due to the ability to learn, think and decide, Human is declared as “Better” in whole living creation in the universe. Education is encouraged in all the religions including Islam. As the First word in the Quran is “Iqra” means Read. From the books of Hadith and the example of Battle of Badar, the importance of education can be found. In the world, normally two types of education sectors are exists, one is regular education with physically existence of classes and second is distance education. In this research, focus of the research team is on Distance Education and Technological Integration in Distance Education along with the flexibility that technology brings to Distance Education in Pakistan. For this descriptive study the data used is gathered from secondary sources such as web sites of distance education universities in Pakistan, head offices and university magazines. For this research, two major distance education universities are discussed which are Allama Iqbal Open University and Virtual University of Pakistan. The Research describes that Distance Education Starts in 1974 in Pakistan and Pakistan has the honor to be the first country in Asia who introduce Open University concept and distance education and 2nd in the World. Allama Iqbal Open University started its distance education initially by hiring the tutors in the different institutions for its student nationwide. However, with IET development the teaching method converted from traditional tutor system to the tutoring broadcast on television and radio network. But the examination system remains as traditional which was paper based examination system along with the paper based assignments for evaluating the student. In 2002, First IT Based University “Virtual University of Pakistan” came into being and developed VULMS Virtual University learning management system. Virtual University of Pakistan is the first IT Based and totally equipped with modern information and communication technology. VULMS contains virtual class room which can be accessed by the student by providing unique student ID and password. VULMS contains video lectures of the student having revise listening option which is better than television broadcast. VULMS allow the student to download their assignment through internet from anywhere and also submit them. It also has the complete section of student Fee record, result record and other services like paper rechecking, freeze and unfreeze the semesters, apply for degree and result card etc. In 2008, Virtual University introduced online examination system which replace traditional paper system in distance education and with online system of education the next step of Virtual University was to introduce the facility of making own date sheet option for the students. By realizing that majority of the students in distance education are professional so this service was given to students. While remaining in the announced exam timing students can select dates, timing and exam city on their own for examination as per their availability. This research describe all the phases of these technological integration one by one phase wise and discuss the impact of these integration in term of brining flexibility for the students of distance education in Pakistan. Keyword: Education, Distance Education, Technology in Education, Education in Pakista

Association between Vitamin D Deficiency and Asthma in childhood

Background: This study was designed to determine relationship between vitamin D deficiency and asthma in pediatric age group as compared to controls. Asthma is among one of the major causes of morbidity in children and it is suggested that vitamin D deficiency plays a role in asthma severity since it has immunomodulatory effects. Methods: This case control study was performed at Benazir Bhutto Hospital Rawalpindi in pediatric department from 2014 to 2015. Cases and controls were recruited from the same hospital through consecutive sampling. Cases were patients with asthma and controls were patients with minor illness other than asthma presenting in outpatient department. The patients who had rickets, known vitamin D deficiency, renal disease, liver disease and other respiratory problems (tuberculosis, pneumonia cystic fibrosis) as assessed on medical records or history and examination were excluded both for cases and controls. Vitamin D levels were checked in all patients. The data was recorded and analysis was done through SPSS 14. Results: The two groups were comparable for age and gender. Mean age of patients in cases was7.66+2.92 while among controls it was 7.23± 2.65 years. Among 30 patients with asthma, vitamin D deficiency was found in 19 (63.33%) while in controls it was found in 8 patients (26.67%). P value was 0.004 which was statistically significant. odds ratio was 4.75, 95 % confidence interval for odds ration showing significant difference between two groups Conclusion: Vitamin D deficiency was remarkably higher in asthmatics in comparison to non-asthmatic children

Immediate Procedural Success of Primary Percutaneous Intervention in Patients with Acute ST Segment Elevation Myocardial Infarction

Objective: To determine the frequency of immediate procedural success of Primary PCI in patients with Acute ST segment elevation Myocardial infarction. Methodology: This observational study was conducted at Cardiology unit of P.I.M.S, Islamabad from April 2018 to October 2018. Study included 43 patients with STEMI. All of them had primary PCI. The main outcome variable was frequency of procedural success which was described as frequency distribution table. Results: Procedural success was achieved among all (100%) patients.  There were 16.3% patients who developed contrast induced nephropathy (recovered), they all were diabetics. There were 4.6% patients who developed hematoma. No other complications seen Conclusions: Immediate procedural success of primary PCI is high (almost successful in every case) and should be offered to the patients with STEMI whenever the facility is available. Keywords: ST-segment elevation myocardial infarction; primary percutaneous coronary intervention

PRIMARY MALIGNANT MELANOMA UTERINE CERVIX

A 40-year-old premenopausal female presented with foul-smelling per vaginal discharge for 3 months. Diagnostic work revealed a locally advanced primary malignant melanoma of uterine cervix. The patient declined pelvic surgery and was treated with Dacarbazine. Malignant melanoma is a rare tumour of skin and has been ranked in the top ve cancers of Australia and Sweden. It is a tumour of melanocytes which forms melanin pigment in the skin. In men, the most common site is trunk while in females common site is limbs. However, melanoma can arise from mucosal surfaces where the melanocytes are present. Most common mucosal sites are head and neck followed by female genital tract. Key words: Cervix, dacarbazine, malignant melanoma

Detection of BCR-ABL kinase domain mutations in CD34+ cells from newly diagnosed chronic phase CML patients and their association with imatinib resistance

BCR-ABL kinase domain (KD) mutations, the most common cause of imatinib resistance, are infrequently detected in newly diagnosed chronic-phase chronic myeloid leukemia (CP-CML) patients. Recent studies indicate pre-existing mutations (PEMs) can be detected in a higher percentage of CML patients using CD34+ stem/progenitor cells, and these mutations may correlate with imatinib resistance. We investigated KD mutations in CD34+ stem cells from 100 CP-CML patients by multiplex ASO-PCR and sequencing ASO-PCR products at the time of diagnosis. PEMs were detected in 32/100 patients and included F311L, M351T, and T315I. After a median follow-up of 30 months (range 8-48), all patients with PEMs exhibited imatinib resistance. Of 68 patients without PEMs, 24 developed imatinib resistance. Mutations were detected in 21 of these patients by ASO-PCR and KD sequencing. All 32 patients with PEMs had the same mutations. In imatinib-resistant patients without PEMs, we detected F311L, M351T, Y253F, and T315I mutations. All imatinib-resistant patients without T315I and Y253F mutations responded to imatinib dose escalation. In conclusion, BCR-ABL PEMs can be detected in a substantial number of CP-CML patients when investigated using CD34+ stem/progenitor cells. These mutations are associated with imatinib resistance, and mutation testing using CD34+ cells may facilitate improved, patient-tailored treatment