Prostate Cancer Microparticles as a Next Generation Screening Tool for Prostate Cancer

Currently available screening tests for prostate cancer (PCa) are neither very sensitive nor specific. Microparticles (MP) are submicron tumor cell fragments released by PCa cells into the circulation and offer a possible means of sampling the tumor. We evaluated the utility of a MP blood test using nanoscale flow cytometry to distinguish patients with PCa from patients with benign prostatic hyperplasia (BPH). We used monoclonal antibodies against prostate specific membrane antigen, gastrin releasing peptide receptor and ghrelin peptide ligand. We found higher but statistically insignificant, PSMA and Ghrelin dual +ve MP counts in the BPH group. Our results show that although MP can be enumerated, better more exclusive surface antigens and different antibodies, are required to test the utility of MP for this to be used as a Next Generation Screening Tool for PCa. In addition, comparison with a more suitable control group would improve accuracy of the experimental test

Glass Ceiling In Pakistan: A Myth Or Reality?

This research intends to explore the existence and concept of glass ceiling in Pakistan .As it is widely cited that glass ceiling refers to the position one wants to achieve and is reachable yet he/she is deprived of that position due to some discriminatory effect. Generally the deprived are the obvious minorities and most certainly the women of society in context with the corporate world. But the emerging role of women as companies CEOs, policy makers and department heads of various companies in Pakistan   motivates this study to find whether it is really gender discrimination being tagged as glass ceiling in Pakistan or is it mere perception leading us away from actual facts. Keywords: Glass Ceiling, Obstacles faced by wome

Recurrent urinary tract infections in females

Uncomplicated Urinary tract infections are common in adult women across the entire age spectrum, with mean annual incidence of 15% and 10% in those aged 15-39 and 40-79 years, respectively. Urinary tract infection (UTI), with its diverse clinical syndromes and affected host groups, remains one of the most common but widejly misunderstood and challenging infectious diseases encountered in clinical practice. Recurrent urinary tract infections (UTIs) present a significant problem for women and a challenge for the doctors who care for them. The diagnosis of uncomplicated UTI can be achieved best by a thorough assessment of patient symptoms with or without the addition of a urine dipstick test. Treatment should be based on the most recent guidelines, taking into account resistance patterns in the local community. The patient who suffers from recurrent UTIs can be treated safely and effectively with continuous antibiotic prophylaxis, post-coital therapy, or self-initiated treatment. This review article covers the latest trends in the management of recurrent UTI among women. Further research is needed regarding rapid diagnosis of UTI, accurate presumptive identification of patients with resistant pathogens, and development of new antimicrobials for drug-resistant UTI

MALT lymphoma of the base of the tongue: a rare case entity

Abstract Lymphoma is a malignant tumour arising from lymphoid tissue, with the majority of cases being in the lymph nodes, however, in 1/4th of cases, these tumours are found in extralymphoid tissue. Lymphoid tissue is also found in organs having mucosa, such as the digestive tract, salivary gland and in tracheal tissue. This collection of lymphoid tissue is known as mucosa-associated lymphoid tissue (MALT), and non-Hodgkin lymphoma involving this extralymphoidal lymph tissue is known as MALT lymphoma. It was first reported by Isaacson and Wright in 1983, however, it was not included as a working diagnosis in clinical use until it was reclassified as \u27marginal zone B-cell lymphoma\u27 in a 1994 Revised European American Lymphoma (REAL) classification. It is rarely seen in the head and neck region, and we report the sixth case of MALT ly

Characteristics of an adult photosensitive cohort

Intermittent Photic Stimulation (IPS) is a well recognized provocation maneuver during EEG recording which helps in identifying underlying photosensitivity. The frequency and characteristics of various responses to photosensitivity among our adult patients was determine. EEGs of subjects \u3e or =15 years from 2003-2006, were reviewed. Two main photosensitive responses were observed: Photoparoxysmal (PPR) and Photic-driving response (PDR). Demographic and clinical data was also collected. Out of 5950 EEG\u27s performed, response to IPS were detected in 1.2% (n=73) of EEGs. Out of which 49 (67%) had PDR and 24 (33%) had PPR. Mean age of PPR group was 25.7 +/- 12 years with equal gender distribution. In PPR subjects, epilepsy was the final EEG conclusion in majority of patients 96% (n=23) p-value \u3c 0.001. Primary Generalized Epilepsy being the most common 52% (n=12). In contrast, PDR observed in normal EEG\u27s was 45% (n=22). This study revealed low frequency 1.2% of photosensitive responses. PPR is seen frequently in patients with epilepsy (96%, p-value \u3c 0.001), and highest rate (52%) of photosensitivity was observed in patients with primary generalized epilepsy

The utility of counterinsurgency in Balochistan (2013-2019) by the Pakistani Security Forces for achieving the safety of the China Pakistan Economic Corridor (CPEC)

This study examines the utility of the Pakistani Army’s Counterinsurgency (COIN) Strategy (2013-2019) in the eradication of perceived threats facing the China-Pakistan Economic Corridor (CPEC) in Balochistan during the ongoing fifth round of insurgency which started in 2006. The year 2013 is a landmark because a MoU for CPEC was signed between Pakistan and China, the same year as the Pakistani Army first promulgated its new counterinsurgency doctrine. This study analyses the institutional learning process of the Pakistani Army, which ultimately resulted in the promulgation of the COIN doctrine and the extent to which the Army adheres to this doctrinal approach in Balochistan. It empirically investigates the efficacy of the COIN strategy in Balochistan after 2013 concerning CPEC security by using David Kilcullen’s ‘three pillars of counterinsurgency model’ as the conceptual framework. The thesis argues that the COIN approach in Balochistan significantly changed after conceptualising the doctrine, especially from 2016 onwards, from ‘butcher and bolt’ to the inclusion of critical components like political primacy, affect-based and focused use of force, winning ‘hearts and minds’ and rules of engagement. As a result, there was a marked reduction in violence, fatalities and an increased number of insurgent surrenders. This thesis concludes that the Pakistani Army has largely controlled the insurgency in Balochistan, but at the same time, the reduction of tangible support to the insurgents through the porous borders and an effective strategy to break the nexus of the Islamic State of Khorasan (ISK) in Balochistan is urgently required to end the insurgency and ensure CPEC’s security. Key Words: Belt and Road Initiative (BRI), China Pakistan Economic Corridor (CPEC), Balochistan, Insurgency, Security, Counterinsurgency (COIN

Triggers of blood transfusion in percutaneous nephrolithotomy

Objective: To determine the triggers of blood transfusion in patients undergoing percutaneous nephrolithotomy (PCNL).Study Design: Observational study.Place and Duration of Study: The Aga Khan University Hospital, Karachi, from 1988 to 2007. Methodology: The percutaneous surgery database was retrospectively reviewed to identify patients with postoperative haemorrhage and need for blood transfusion. Blood loss was estimated by the postoperative drop in haemoglobin factored by the quantity of any blood transfusion. Various patients and procedure-related factors were assessed for association with total blood loss or blood transfusion requirement using stepwise univariate, forward multivariate regression analysis.Results: A total of 326 procedures were performed in 316 patients. Two hundred and thirty two procedures were included in the study. There were 167 males and 65 females. The mean age was 41+14 years. The mean haemoglobin drop was 1.68 +1.3 gm/dL. The overall blood transfusion rate was 14.2%. Stepwise multivariate regression analysis showed that female gender (p = 0.003), staghorn stone (p = 0.023), stone fragmentation with ultrasound (p = 0.054) and chronic renal failure (p = 0.001) were significantly predictive of the need for blood transfusion. Conclusion: Chronic renal failure, female gender, presence of staghorn calculi and stone fragmentation using ultrasonic device were predictive of blood transfusion in this cohort of patients