Ki-67 expression in astrocytomas

Objective: To apply immunohistochemical marker Ki-67 and to check it’s expression in various types of Astrocytomas according to their grades. Methodology: The cross sectional study was conducted in Pathology department, Federal Government Services Hospital (Polyclinic), Islamabad  from July to December 2015. All patients having diagnosis of astrocytomas grade II, III and IV on histopathology were included in the study. Microscopic examinations were carried out for accurate diagnosis and grading of astrocytomas. Immunohistochemical staining for Ki-67 was done and the percentage of cells with positive Ki-67 nuclear staining was determined. Quotients (positively stained tumor cells/totally counted tumor cells) were calculated as percentage and rounded to nearest integer. Result: A total of 212 patients were included in the study. The mean age of the patients was 40.16 ± 12.763 years (Range 20 to 76 years). Majority of the patients (32%) were in age range of 30-40 years. In this study, 110 of 212 patients (51.9%) were males while 102 patients (48.1%) were females. Among the three types of Astrocytomas, Glioblastoma multiforme (WHO grade IV) was the most common variant. Overall Ki-67 staining was positive in 168 of 212 specimens (79.2%) and most commonly was in Glioblastoma multiforme WHO grade IV being 96.3%.  Stratification of Ki-67 expression in tumors was also done according to age and gender of cases. P-value was found significant after stratification (P <0.05) Conclusion: Ki-67 staining was positive in 79.2% cases of Astrocytomas and most commonly (96.3%) positivity was in Glioblastoma multiforme WHO grade IV. Increasing values of Ki-67 are associated with increasing grade of malignancy

The Expression of Progesterone Receptors in Meningiomas of Different Grades

Background: Meningiomas are slow growing intracranial and intraspinal neoplasms with a tendency to recur locally. WHO grades them as I (benign), II (atypical) and III (anaplastic) in order of their increasing aggressiveness, based on histological parameters and brain parenchymal invasion. Progesterone receptors (PR) are more prevalent amongst the lower grade meningiomas. The objective of this study was to determine the immunohistochemical expression of progesterone receptors in meningiomas of different grades.Material and Methods: A total of 100 cases were selected over a period of 2.5 years. Three to five microns’ thick sections stained with Hematoxylin and Eosin were examined microscopically by a team of two Histopathologists and graded into grades I, II and III, according to 2016 WHO classification criteria. Another section of the original tumor was stained with progesterone receptor antibody using the conventional immunoperoxidase method. Stained slides were than examined by the same team of Histopathologists and declared positive (if nuclear staining was observed in more than 10% of tumor cells) or negative. Statistical analysis was done using SPSS version 21.Results: Out of a total of 100 cases of meningioma, there were 79 cases of benign/typical WHO grade I, 15 cases of atypical/ WHO grade II and 6 cases of anaplastic/ WHO grade III tumor. PR status was positive in 89.8 % (71/79) of grade I meningiomas and 46.6 % (7/15) of grade II/Atypical meningiomas. The 06 cases of Anaplastic/WHO grade III tumors were negative for PR. There was a higher prevalence of Progesterone receptors in female patients (89.8%; 53/59) as compared to male meningioma patients (60.9%; 25/41).Conclusion: We observed a decreased expression of progesterone receptor in higher grades of meningioma in this study. It is an effort to explore conservative treatment options for inoperable lesions, as anti-progesterone therapy may hold a promise as a new treatment option in the near future

Non Surgical Causes of Acute Abdomen in Children: Surgeons Standpoint for Exclusion

Objectives: The aim of this study is to find out the non-surgical causes of acute abdomen, their frequencies, and to make an algorithm to make a methodology for excluding surgical abdomen. Methodology:  This descriptive case series study was carried out in departments of pediatrics and surgery in Aero hospital from January 2021 to November 2022. One hundred children with acute abdomen who were referred for surgical opinion and found to have non-surgical abdomen were included in the study. Surgical causes were ruled out after serial examinations and investigations by consultant surgeons. All non-surgical causes, their frequencies of presentation were recorded and an algorithm was made. Descriptive data was analyzed using SPPS version 25. Results: Gastroenteritis was found to be the most important cause of non-surgical acute abdomen and found in 23% (n=23) children followed by 18% (n=18) mesenteric lymphadenitis, nonspecific abdominal pain 12% (n=12), UTI 7% (n=7), worm infestation 7% (n=7), enteric ileitis 06% (n=6), Covid 05% (n=5), hepatitis 05%(n=5), constipation 04% (n=4), dengue 4% (n=4), ruptured ovarian follicle 3% (n=3), renal calculi 2% (n=2), Henoch schonlein purpura 2% (n=2) and gastritis 2% (n=2). An algorithm also made at the end of study to help treating surgeons to rule out surgical abdomen. Conclusion: Gastroenteritis is the leading cause of acute non-surgical abdomen in children along with many other causes and these must be carefully ruled out by an algorithm to avoid unnecessary surgeries

Genetic Polymorphism of UDP-Glucuronosyltransferase

Genetic polymorphism is referred to the discontinuous interspecies genetic variability among individuals having distinct alleles on a particular locus. Genetic polymorphism of genes encoding drug-metabolizing enzymes constitutes individual’s susceptibility to drugs, affirmed by having discrete allelic frequencies by the individual, strengthening the concept of precision medicine. To combat with toxic consequences of drugs, the polymorphic genes associated with xenobiotic metabolism must be studied. Up to 70% xenobiotic elimination is believed to be dependent on UDP-glucuronosyltransferase (UGT), an enzyme encoded by polymorphic UGT1A and UGT2B genes. Both bimodal and trimodal distribution patterns of UGT have been reported in various human populations studied. Genetic polymorphisms of UGT may even lead to truncated and shorter gene with grossly diminished enzymatic activity. The extent of phenotypic alteration inflicted by genetic polymorphisms depends on its nature and position on gene locus. The different isoforms of UGT superfamily differ from each other regarding substrate specificity and selectivity. The incidence of genetic polymorphisms and associated altered gene functions results in inter-individual variability in metabolic clearance and elimination of drugs. Hence, the critical interaction between genetics and biotransformation of drugs has recently been the focus of pharmacology research

Incidence Of Hypoparathyroidism After Total Thyroidectomy for Benign Goitres. A Systematic Review

Objective:  systematic review assessed the overall incidence of hypoparathyroidism after Total thyroidectomy (TT) for benign goitres. Methods: A systematic search of PubMed, google scholar, Cochrane, and Pakmedinet under PRISMA (preferred reporting items for systematic reviews and Meta-analyses) guidelines was performed. All studies during the last 50 years where TT was performed for benign goitres and post-operative hypoparathyroidism was assessed were included.  The total incidence of both transient and permanent hypoparathyroidism was calculated after TT for benign goitres. The risk of bias was also assessed. Results: Twelve studies were included in total including eight retrospective, three prospective observational studies, and one randomized trial. Three studies were from Turkey, 2 from Pakistan, 2 from Greece, and one each from Saudi Arabia, India, Denmark, Egypt, and the USA. 2809 TT were performed for benign goitres. Overall Transient hypoparathyroidism (THP) was noted in 290 (10%) patients while permanent hypoparathyroidism (PHP) was noted in 33(1.17%) patients. The highest incidence of permanent hypoparathyroidism was 17% in one study while the lowest was 0% in three studies. The highest incidence of transient hypoparathyroidism was 28.5% in one study while the lowest incidence was 2.5%. The risk of bias was high. Conclusion: TT for benign goitres is associated with 1.17 % overall risk (range 0%-17%) of PHP and 10% (range 2.5%-28.5%) of THP

Pathogenesis of hematological parameters in hypertension

Hypertension, which is a significant risk factor for cardiovascular disease, is often assessed in clinical settings using reference ranges for various haematological and immunological parameters. Research has indicated that specific haematological parameters, such as red blood cells, red cell distribution width, mean cellular/corpuscular haemoglobin, mean cellular/corpuscular haemoglobin concentration, haemoglobin, hematocrit, mean cellular/corpuscular volume, platelet count, white blood cells, basophils, lymphocytes, neutrophils, monocytes, eosinophils, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, have a role to play in the development of hypertension. This review article focuses explicitly on the pathophysiological aspects of haematological parameters in the pathogenesis of hypertension

Effect of High-Intensity Circuit Training versus Low-Intensity Interval Training on Functional Strength and Weight Efficacy in Overweight and Obese Young Females: A Randomized Clinical Trial

Objective: To compare the effects of high-intensity circuit training (HICT) versus low-intensity interval training (LIIT) on functional strength and weight efficacy in overweight and obese young females. Methods: This randomized clinical trial was conducted at Ladies Club Gujranwala Cant, Pakistan from March 2021 to January 2022. Participants, aged 18-35, were randomly assigned to HICT or LIIT groups. Functional strength th and weight efficacy were taken as outcomes and measured at baseline and the 8 week after the interventions. Leg levers, modified push-ups, squats, cordless skipping, and burpees were used to test functional strength. The Weight Efficacy Lifestyle Questionnaire Short Form (WELQS) was used to measure weight efficacy. Results: Of total 34 of young females (17 in HICT and 17 in LIIT group), the median waist circumference was found significantly higher in the HICT group as compared to the LIIT group i.e., 39.0 (37.0 – 42.5) inches vs. 36.0 (33.0 – 38.5) inches (p-value 0.046) respectively. Similarly, the median hip measurement of the females was found significantly higher in the HICT group 45.0 (40.5 – 48.0) inches as compared to the LIIT group 41.0 (39.0 – 44.5) inches (p-value 0.029). Within-group comparison at baseline and after 8 weeks showed a significant median difference, with pushups, leg levers, burpees, left leg squats, right leg squats, skipping, and weight efficacy (pvalue <0.001) respectively. Conclusion: This study concludes that both HICT and LIIT improved functional strength and weight efficacy in overweight and obese young females. However, HICT led to significantly greater improvements in functional strength as compared to LIIT

INCIDENCE OF DENGUE HAEMORRHAGIC FEVER IN LOCAL POPULATION OF LAHORE, PAKISTAN

ABSTRACT Dengue virus infection is the most common mosquito born viral disease and is a major public health problem (globally). More than 2.5 billion people in over 112 countries of the world are at risk from dengue virus. According to WHO, more than 100 million new cases of dengue fever occur world wide including dengue haemorrhagic fever (500,000) cases and Dengue Shock Syndrome (DSS) along with 2.5% mortality rate. In Pakistan incidence of dengue is increasing since 1994 and is becoming an important public health problem. Among the 341 acute cases, 166 (48.7%) were confirmed by IgM dengue specific kit, 27 (7.9%) in gray zone and 148 (43.4%) were negative. IgG was used on 200 suspected re-infected patients. Among them 79 (39.5%) were positive, 3 (1.5%) in gray zone and 118 (59%) were negative. Male to female ration was 1.25:1. Most patients presented typical sign and symptoms of fever, headache, myalgia, anorexia, malaise, skin rash and retroorbital pain in 98, 81, 75, 63, 47 and 41% respectively in descending order. Among 245 confirmed dengue fever patients 43 (17.6%) were considered dengue haemorrhagic fever cases on the basis of lab and clinical findings. More prevalence has been observed in old age (37.8%) as compared to children (7.1%) in age group 1-15 years. Continuous surveillance and education of the clinician is essential for the recognition of the risk factors of dengue haemorrhagic fever for early diagnosis and management

Innovative Application for Monitoring Child Behavior Using Play Therapy

Devices such as cell phones, tablets, laptops, etc., have become children's material support when parents neglect them. Without emotional support, and little parental guidance children will eventually suffer from insecurity, depression, and anxiety. Thus, to bridge this gap called emotional detachment between parents and their children, this research will introduce an android-based application called Child Psychology Monitoring and Learning System (CPMLS), which is designed to assist parents in monitoring their child's psychological state. It is designed for children between the ages of 3-9 years and is grouped into three categories, i.e., 3-5, 6-7, and 8-9, respectively. Within this application, various digital games will test the child's emotional and social intelligence using play therapy. As a result, parents can keep track of what their child is experiencing on a psychological level. It has been observed that the react world activity give the prediction of about 30 percent shyness, 25 percent arrogance, 40 percentage isolation, and five percentage child abuse and approximately 30 percentage focused, 45 percentage Impatient, and 25 percentage dedicated results were obtained from the beat-the-clock activity

HDL-IDS: A Hybrid Deep Learning Architecture for Intrusion Detection in the Internet of Vehicles

Internet of Vehicles (IoV) is an application of the Internet of Things (IoT) network that connects smart vehicles to the internet, and vehicles with each other. With the emergence of IoV technology, customers have placed great attention on smart vehicles. However, the rapid growth of IoV has also caused many security and privacy challenges that can lead to fatal accidents. To reduce smart vehicle accidents and detect malicious attacks in vehicular networks, several researchers have presented machine learning (ML)-based models for intrusion detection in IoT networks. However, a proficient and real-time faster algorithm is needed to detect malicious attacks in IoV. This article proposes a hybrid deep learning (DL) model for cyber attack detection in IoV. The proposed model is based on long short-term memory (LSTM) and gated recurrent unit (GRU). The performance of the proposed model is analyzed by using two datasets—a combined DDoS dataset that contains CIC DoS, CI-CIDS 2017, and CSE-CIC-IDS 2018, and a car-hacking dataset. The experimental results demonstrate that the proposed algorithm achieves higher attack detection accuracy of 99.5% and 99.9% for DDoS and car hacks, respectively. The other performance scores, precision, recall, and F1-score, also verify the superior performance of the proposed framework