Hepatitis C virus infection is the major cause of severe liver disease in India

The present study describes the status of hepatitis C virus infection in 167 patients with severe forms of liver diseases in India. The anti-HCV positivity rate was recorded as 43%, 47% and 42% in patients with FHF, SAHF and CAH respectively. HBV and HCV coinfection was recorded in 28% of FHF, 43% of SAHF and 75% of the CAH cases. Superinfection of HCV in HBsAg carriers was recorded in 54% cases of FHF, 60% of SAHF and 42% of the CAH. None of these 167 patients was positive of HAV-IgM. Further, 27.7% of FHF, 26.4% of SAHF and 15.2% of CAH cases were neither HBV nor HCV markers positive. These can be labelled as non-A, non-B and nonC infections

Clinico-morphological pattern of intracranial tumors in children

Objective: The objective of present study was to observe the histopathological pattern of intracranial tumors in children (\u3c 15 yrs) and to correlate the site of lesion along with the histological diagnosis. Setting: The study included consecutive cases of intracranial tumors diagnosed in children (\u3c 15 yrs.) in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of three years. Methods:The initial histological evaluation of these lesions was performed on H and E stained section of paraffin embedded tissue. Special stains and immunohistochemical analysis was done whenever indicated. Results:During the study period, fifty-four cases of intracranial tumors were diagnosed in children. The age ranged from 1-1/2 years to 4 years with male to female ratio of 1.1:1. Astrocytoma comprised 39% of all intracranial tumors of childhood. Medulloblastoma (18.6%) ranked the second most prevalent brain tumor followed by empendymoma (13%), oligodendroglioma 7.5% while non-Hodgkin\u27s lymphoma, primitive neuroblastoma 3.7% and ganglioglioma 3.7% while non-Hodgkin\u27s lymphoma, primitive neuroectodermal tumors, mixed germ cell tumor, pineoblastoma, choroid plexus carcinoma and malignant meningioma constituted 1.8% each. Conculsion: Astrocytoma was the most common pediatric brain tumor. Medulloblastoma was more common in males while pilocytic astrocytoma was more frequent in females. Posterior cranial fossa was the most common site (43.5%) of pediatric brain tumors. Low grade astrocytoma was more prevalent in posterior cranial fossa as compared to high grade astrocytoma which was more frequent in the supratentorial region

Clinico-morphological pattern and frequency of bone cancer

Objective: The present study was done to find out the frequency of malignant tumors of bone and to categorize the prevelence of various histological types of osseous malignancies with respect to age, sex and site of origin. Setting: This study included consecutive cases of malignant bone tumors, which were diagnosed in the department of pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997). Methods: These tumors were initially evaluated on H & E stained section from paraffin embedded tissue blocks. Special stains and immunohistochemical analysis was performed whenever required. Results: A total of 169 malignant bone tumors were diagnosed during the study period. Metastatic tumors accounted for 28.4% of all malignant tumors of bone. Osteogenic sarcoma (27.2%) was the most frequent primary tumor of bone followed by Ewing’s sarcoma (12.4%), Non- Hodgkin’s lymphoma (10.6%), Chondrosarcoma (8.3%), Plasma Cell Myeloma (8.3%) and other rare entities (4.8%) in order of frequency. Conclusion: The most common malignant neoplasm diagnosed in osseous biopsies was metastatic tumors. Osteogenic sarcoma was the most frequent primary bone tumor in this series. The bone tumors were relatively more prevalent in males. The frequency of malignant bone tumor was relatively high as compared to developed countries

Safety compliance for hihg rise projects in Nigerian construction Industry

Health and safety issues had always been a major challenge and concern in the construction industry. Construction is found to be one of the most dangerous on health and safety practice, predominantly in developing countries. As construction accidents continue to dominate the overall construction industry. Despite the programs implemented by government and measures introduced by companies the number of high rise construction accidents still remains alarmingly. This research aim to investigate the safety compliance for high rise construction project in Nigeria. In achieving this aim three (3) objectives has been outlined; to investigate the current level of compliance to safety practice and policies in Nigerian construction site. To investigate the factors that prevent the compliance to safety and health practices in high rise projects of Nigerian construction industry. To recommend appropriate ways to improve the compliance to safety in high rise of Nigerian construction. The interview and questionnaire method was used in this research. Structured Questionnaires was distributed to 108 potential respondents from the construction industry players 90 was returned and Qualitative interview have been conducted to meet the first objective of the project, to investigate the current level of compliance to safety practice In addition, structured interviews were carried out with selected managers from construction industry. The result shows that Bribery and corruption, Lack of training, Absence of safety representatives, Lack of corporate responsibility & Accountability, Weak legal structure were the significant factors affecting safety. Compliance. The result also indicate that Site inspection, Safety seminars (enforcement officers), Building codes of practice, Enforcement of safety act, Workers/labourers training are the effective factors that could improve compliance to safety practice in high rise project of Nigerian construction industry. It is recommended that relevant authorities should checkmate the Safety practices in the Nigerian construction industry

Factors affecting continuation of clean intermittent catheterisation in people with multiple sclerosis: results of the COSMOS mixed-methods study

Background:  Clean intermittent catheterisation (CIC) is often recommended for people with multiple sclerosis (MS).  Objective:  To determine the variables that affect continuation or discontinuation of the use of CIC.  Methods:  A three-part mixed-method study (prospective longitudinal cohort (n = 56), longitudinal qualitative interviews (n = 20) and retrospective survey (n = 456)) was undertaken, which identified the variables that influenced CIC continuation/discontinuation. The potential explanatory variables investigated in each study were the individual’s age, gender, social circumstances, number of urinary tract infections, bladder symptoms, presence of co-morbidity, stage of multiple sclerosis and years since diagnosis, as well as CIC teaching method and intensity.  Results:  For some people with MS the prospect of undertaking CIC is difficult and may take a period of time to accept before beginning the process of using CIC. Ongoing support from clinicians, support at home and a perceived improvement in symptoms such as nocturia were positive predictors of continuation. In many cases, the development of a urinary tract infection during the early stages of CIC use had a significant detrimental impact on continuation.  Conclusion:  Procedures for reducing the incidence of urinary tract infection during the learning period (i.e. when being taught and becoming competent) should be considered, as well as the development of a tool to aid identification of a person’s readiness to try CIC

Immunohistochemical evaluation of small round cell tumors of childhood

Objective: This study was done to evaluate the pediatric undifferentiated small round cell tumors with immunohistochemical staining. Setting: The present study included consecutive cases of small round cell tumors which were diagnosed in children (\u3c15 years) in the section of Histopathology at the Aga Khan University Hospital, Karachi during the period of two years. Methods: The group of undifferentiated small round cell tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks. Results: The category of undifferentiated small round cell tumors included rhabdomyosarcoma (23.2%), primitive neuroectodermal tumor (17.9%), non-Hodgkin’s lymphoma (16.1%), neuroblastoma (14.2%), Ewing’s sarcoma (10.7%) in order of frequency. Osteosarcoma (Small cell variant), retinoblastoma and medulloblastoma comprised 1.8% each. In seven cases (12.5%), the immunohistochemical analysis was inconclusive. Conclusion: Immunohistochemistry is a very valuable diagnostic tool which helps in distinguishing the undifferentiated tumors especially small round cell tumors. The immunohistochemical staining needs to be performed routinely for undifferentiated tumors in diagnostic histopathology

Hepatitis B virus replication in patients with chronic liver diseases

One hundred and seventy five subjects with chronic liver diseases which included patients with chronic active hepatitis (90), liver cirrhosis (31) and asymptomatic hepatitis B carriers (54), were included in the study. Hepatitis B virus (HBV) specific DNA-polymerase activity and HBe-markers were tested as markers of HBV-multiplicaiton. In HBsAg positive samples, DNA-P activity was positive in 44.4% of the HBV carriers, 52.9% of the patients with chronic active hepatitis and 81.8% of the patients with liver cirrhosis. The corresponding figures for the presence of HBeAg in these groups were 18.5, 26.5 and 45.5% respectively. Virus multiplication was also observed in 41.1 and 44.4% patients with chronic active hepatitis and liver cirrhosis respectively, in the absence of HBsAg. The results of the present study show that hepatitis B virus is the most important etiological factor of chronic liver diseases in India. Most of our patients of chronic liver diseases seems to have contacted HBV infection as young adults and the mode of transmission is likely to be horizontal rather than vertical. The virus replicating markers correlate well with the severity of the liver injury and decreased with the age. DNA-P activity is a more sensitive marker of viral multiplication than HBeAg. Viral multiplication was also found to occur in the absence of the usual HBV markers. Continued viral multiplication in patients with chronic active hepatitis and liver cirrhosis is implicated in continued liver injury and progressive liver disease