Non-invasive diagnostic tools in early detection of oral epithelial dysplasia

Objective: The incidence of oral cancer worldwide varies 2-18% and in India 0.1 to 13.5%. Early evaluation of oral precancerous lesions can have dramatic effect on oral cancer mortality rate. Among the premalignant stage, leukoplakia is the most commonly encountered clinical lesion and epithelial dysplasia is most important predictive factor. The objective of this paper is to compare the efficacy of exfoliative cytology, toluidine blue and chemiluminescent illumination (VIZILITE) to detect early dysplastic changes in leukoplakia. Study design: Study involved 50 patients of leukoplakia (homogeneous, speckled) in the age group of 20-72 years including males and females in the ratio of 7:3. All the diagnostic procedures were carried out on each patient followed by biopsy and data was subjected to statistical analysis. Results: Comparing the results of exfoliative cytology with toluidine blue in diagnosing dysplasia in leukoplakia, it showed 50% sensitivity and 83.3 % specificity. In comparison to chemiluminescent light examination, cytology showed 42.9% sensitivity and 79.3% specificity. Chemiluminescent light examination showed 60% sensitivity and 70% specificity compared to toluidine blue. Conclusions: Overall accuracy of exfoliative cytology was less than toluidine blue, whereas latter showed superior but comparable results to chemiluminescent illumination in detecting dysplasia. However role of chemiluminescent illumination should be further investigated in demarcating dysplatic lesion

Oral manifestations of Type I Neurofibromatosis in a family

Neurofibroma is a benign peripheral nerve sheath tumor. It is one of the most frequent tumors of neural origin and its presence is one of the clinical criteria for the diagnosis of neurofibromatosis type I (NF-I). Neurofibromatosis type I is an autosomal dominantly inherited disease due to an alteration in the long arm of chromosome 17. About 50% of NF-I patients have no family history of the disease. NF-I patients have skin lesions (café au lait spots and neurofibromas) as well as bone malformations and central nervous system tumors. Diagnosis is based on a series of clinical criteria. NF-I presents with certain definite oral manifestations which confers to the dentists a major responsibility for accurate diagnosis and report of the disease. The paper aims to highlight the role of an oral diagnostician in first recognition of NF-I in a family via manifestations in the oral cavit

Parry Romberg Syndrome with localized scleroderma: a case report

Parry Romberg syndrome(PRS) is a rare acquired poorly understood neurocutaneous syndrome of unknown etiology characterized by slow progressive atrophic changes commonly affecting one half of the face. The exact incidence and etiology towards the syndrome remains unclear. Apart from the multifactorial etiology proposed, the possible primary cause is mainly attributed to the cerebral disturbance of the fat metabolism. The syndrome over - laps with "en coup de sabre" morphea, with an ill defined relationship existing between the two. Parry Romberg Syndrome is an invalidating lesion that may be associated with different neurological, cutaneous, ocular, dental and autoimmune abnormalities. This report presents one rare case of 22 years old female patient with Parry Romberg syndrome associated with localized scleroderma, accompanied by a brief review of literature with classical clinical, radiographic, histological findings and the treatment of progressive hemifacial atrophy

Modeling the Role of Maternal Care in the Educational and Health Development of the Children

Mothers play different roles in their family which has an effect on  health and well being of all members of the family specially on children. Almost in all different societies around the world, they have been assigned to be primary care-givers to infants and children. The present study investigates the relationship of maternal care and its effects on the educational performance and health of children in Pakistan from a statistical perspective. The modeling and significance has been established by measures of association and automated linear regression

Isolation and structure elucidation of a new oleanane type glycoside from the aerial portion of Cestrum nocturnum

Cestrum nocturnum (Solanaceae) is an ornamental plant cultivated in various parts of the world due to its sweet-scented white flowers. It is commonly called night-blooming Jessamine (Raat ki Rani). The genus is known for its toxicity to feedents. The leaves may cause uneasiness in animals which may lead to severe gastroenteritis. The plant is known to be a rich source of pharmacologically active saponins. Looking to its various pharmacological activities as reported, the plant was explored for the isolation of new phytochemicals. During the process, a new oleanen type glycoside was isolated from the butanolic fraction of the leaves of Cestrum nocturnum and was characterized as 3-O-β-D-xylopyranoside-olean-12-en-28-oic acid-28-O-β-arabinopyranosyl-(1-3)-β-D-galacto-pyranosyl-(1-2)-β-D-glucopyranosyl-(1-4)-β-D-glucopyranosyl ester, along with two reported compounds nocturnoside A and karativoside A. The structure was elucidated on the basis of 1D and 2D NMR and mass spectrometry.   Bull. Chem. Soc. Ethiop. 2020, 34(1), 141-148. DOI: https://dx.doi.org/10.4314/bcse.v34i1.1

An Empirical Examination of E-Government Virtual Services: Mediating Role of Users’ Perceived Usefulness

Government websites are the repository of information where citizens can timely access substantial and reliable information. It is normal to find antagonism between formulators and users of e-government virtual services (EGS). This study is designed to assess the quality of virtual services provided by Pakistani government websites. Data is collected from 278 university graduates using simple random sampling technique. Results of Smart PLS show that the survey respondents exhibit positive attitude towards perceived system quality (PSQ) and perceived information quality (PIQ) of the websites. They also perceive e-government websites useful and display their satisfaction to e-government virtual services. Finally, findings provide support to mediating role of users’ perceived usefulness (UPU). Policymakers and practitioners can take advantage of the findings to design more citizen centered government websites to optimize their satisfaction with mandatory services

Comparative study of safety and efficacy of pregabalin and gabapentin in management of neuropathic pain associated with chronic lumbar radiculopathy

Background: Chronic lumbar radiculopathy a clinical condition in which there is back and leg pain associated with sensory, reflex, or motor deficits in the area of nerve root distribution lasting for more than 12 weeks. The prevalence of lumbar radiculopathy has been reported to be 5.3% in men and 3.7% in women. Pregabalin and gabapentin, which fit in to a new category of drugs called as alpha-2-delta (α2δ) modulators, have been discovered to be effective in the treatment of neuropathic pain related with multiple conditions. So this study was done to compare safety and efficacy of pregabalin and gabapentin in management of pain associated with chronic lumbar radiculopathy.Methods: This was a randomized two arm comparative prospective study. Total 160 patients were enrolled and randomized equally into 2 groups. Group A patients were given capsule pregabalin 75 mg two times a day orally, Group B patients were given tablet gabapentin 300 mg two times a day. Pain intensity was assessed at the start of study i.e. at baseline (0 week), at 6 weeks and at 12 weeks of starting the treatment using numeric pain rating scale.Results: There was significant reduction in pain at the end of 12 weeks in both the groups (p<0.0001), but there was no significant difference between these two groups. The incidence of adverse effects was also more in group A.Conclusions: Both the drugs are having comparable efficacy but gabapentin is more tolerable in such cases

Laparoscopic appraisal of infertility and pelvic pain in Pakistani women: a 5 years audit

Five hundred and nine Laparoscopic examinations performed between 1987-91, (147 procedures for evaluation of gynaecologic pelvic pain and 313 for infertility) revealed ectopic pregnancy (27%), twisted ovarian cyst (18%) and acute pelvic inflammatory disease (14%) in cases of acute gynaecologic pain, and endometriosis (17%) and chronic pelvic inflammatory disease (16%) in chronic pelvic pain. Adhesions (20%), tubal block (15%), endometriosis (9%) and polycystic ovary (7%) were common findings in cases of infertility. These data support the usefulness of this minimally invasive procedure in accurate diagnosis of gynaecological disorders and provides insight into the spectra of diseases seen in Pakistani women with pelvic pain and infertility

Comparative study to evaluate efficacy and safety of azilsartan and telmisartan in patients with grade I-II essential hypertension

Background: Objectives of the study was to study the effect of Azilsartan 40mg once daily versus Telmisartan 40mg once daily in patients with Grade I-II essential hypertension.Methods: A prospective study was conducted at MGM Medical college and Hospital which included 80 patients in each group with Grade I–II essential hypertension. The sex, age, presenting illness, and family history of the patients were recorded. Investigations such as blood sugar, urine analysis, kidney function test, lipid profile, and ECG were performed before starting the treatment. Any adverse effects during the treatment were noted. Blood pressure was recorded at baseline and during follow-up. One group received Azilsartan 40mg once daily and another group Telmisartan 40mg once daily. Patients were followed-up every week for 5 weeks.Results: Patients receiving Azilsartan 40mg and Telmisartan 40mg showed a significant fall (P 0.05). Adverse effects such as Nasopharyngitis, Upper respiratory tract inflammation, Gastroenteritis, headache, dizziness, and fatigue were reported with both drugs.Conclusions: Reduction of blood pressure with Azilsartan and Telmisartan was similar, but fall in blood pressure from baseline was highly significant in both groups