Role of MicroRNA in Breast Cancer

Breast Cancer is the commonest cancer affecting women worldwide especially in Asia. Several proteinaceous,genetic andepigenetic biomarkers areallied with the disease but their efficacy as vigorous and robust indicators of disease remains uncertain.The need to detectand differentiate aggressive from non-aggressive breast tumors at cellular level is being investigated.MicroRNAs seem to be a promising marker to identify the disease before it reaches aggressive level. MicroRNAs (miRNAs)are small 18-24 nucleotide RNAs which regulate the expression of approximately 30% of human genes. Their expression isfrequently deregulated in cancers. .miRNAshave been found in significantly large copy numbers in serum/plasma of cancerpatients. The stability of the serum miRNAs is not compromised even if the samples are treated with RNase or incubated atroom temperature over prolong periods or subjected to repeated freeze-thaw cycles. miRNAs that are breast cancer-specificcan therefore be employed as disease predicting biomarkers.Keywords:Breast cancer, Micro RNA, Role, Serum, Stability

Effect of age on uterine and ovarian morphology with polycystic ovaries

Abstract Objective: To measure the outcome of age on ovarian and uterine morphology in primary infertile women with polycystic ovaries. Methods: The observational cross-sectional study was conducted from January 2009 to March 2010, and the subjects were recruited from Ziauddin Hospital, Nazimabad, Karachi. The primary infertile subjects with polycystic ovaries were subdivided into two age groups:20-30 years (group I), and 31-40 years (group II). Both groups had equal number of subjects. The ovarian volume, follicles count and size, uterine area and endometrial thickness were determined by transabdominal and transvaginal scans. Shapiro-Wilk\u27s test and Mann-Whitney test were applied, with p\u3c0.05 being significant. Results: There were 200 female subjects in the study who were divided into two equal age-based groups of 100(50%) each. The mean age of group I was 26.46±3.55 years and that of group II was 36.73±3.19. An increase in uterine area from 89.99±5.83 to 119.0±23.33 (p\u3c0.03) and endometrial thickness from 0.48±0.11 to0.59±0.13 (p=0.01) was observed in group II. A decline in follicular count and size was also noticed in group II (p\u3c0.02, p=0.001).Ovarian volume declined from 15.36±2.56 to 10.57±1.29 (p=0.001)in group II. A positive correlation of age with uterine area (r=0.202; p\u3c0.003) and endometrial thickness (r=0153; p\u3c0.025) was noticed. Conclusion: Ovarian morphology decreased in the elder infertile group of women with polycystic ovaries, but the uterine morphology variables showed an increase in area with thickening of the endometrium in the elder group

Impact of structured meetings on the learning of faculty members

Objective: To determine impact of structured meetings on learning and faculty developmentMethodology: The observational cross sectional study was conducted at Bahria University Medical &Dental College from October 2010 to March 2011. Feed back of all faculty members of university wasacquired on weekly structured meeting (with alternating theme of journal club and problem based scenariopresentation) by a self reported questionnaire. The responses obtained on a 5-point Likert scale weredivided into two groups; I, senior faculty (professors, associates and assistants) II, junior faculty(lecturers). Chi square test was applied to compare categorical variables and results considered significantwith p value\u3c 0.05.Result: 49 faculty members; 15 in Group I and 34 in Group II responded, 90% respondent considered it tobe a healthy activity. Senior faculty agreed to the usefulness of structured meetings in terms of facultydevelopment, social interaction, provision of learning opportunities, upgrading of presentation,communication, listening and critical appraisal skills, understanding of biostatistics, self awareness,personal productivity and tolerance to listen to criticism more than the junior faculty (p-value 0.000).Conclusion: The perception regarding weekly structured meeting indicated that it enhanced faculty\u27sknowledge, improved presentation skills, enhanced confidence level, developed positive attitudes andpromoted educational leadership qualities in the faculty all through interaction and dialogue

Anatomical Variations of Rhinogenic Headache and Its Relation with Sinusitis: A Computerized Tomography (CT) Scan Study

Background: Variable anatomy, hallmark of sinonasal region is the reason for the etiology of sinonasal symptoms such as rhinogenic headache. This study aimed to investigate the incidence of anatomical variations of the nasal cavity and paranasal sinuses in sinusitis patients with complaint of rhinogenic headache on computed tomography of paranasal sinuses, and the correlation of these variants with a rhinogenic headache. Methods: A prospective cross-sectional study (n=50) of 18-60 years having sinusitis with rhinogenic headache was steered at the Department of Radiology in the PNS Shifa Hospital of Karachi, Pakistan, between June-December 2021. After obtaining written informed consent, all subjects were investigated for various anatomical variants of the sinonasal region detected on computed tomographic scans of paranasal sinuses and were correlated with a rhinogenic headache. The Chi-square test and Pearson correlation were applied for statistical analysis and the level of significance was set at p≤ 0.05. Results:  The most common anatomical variant of sinonasal region detected was agger nasi cells 32(64%) (Right: r/r -0.24, p =0.09; Left: r/r -0.28, p = 0.04), followed by deviated nasal septum 28(56%) (r/r 0.04, p= 0.75), concha bullosa 23(46%) (r/r 0.07, p=0.59), deviated nasal septum with bony spur (r/r 0.07, p=0.62) and other variants. The overall, study found male (68%) predominance. Significant association existed between rhinogenic headache and some of the anatomical variants along with sinus mucosal thickening (p<0.05). Conclusion: The significant association (p<0.05) was found between rhinogenic headache and different anatomical variants like agger nasi cells, left-sided agger nasi cells, right-sided Haller’s cells, left-sided maxillary and ethmoid sinusitis. Keywords: Rhinogenic Headache; CT-PNS; Sinonasal Region; Anatomical Variants

Translating knowledge for action against stroke – using 5-minute videos for stroke survivors and caregivers to improve post-stroke outcomes: study protocol for a randomized controlled trial (Movies4Stroke)

Participant timeline. (DOCX 48 kb

Use of Computed Tomography for Nasal and Paranasal Anatomic Variants

Augmentations and improvements in sinus surgical methods and computed tomography (CT) have concurrently elaborated interest in variable anatomical features of the nasal cavity and paranasal sinuses (PNS). Anatomical variations are normal morphological structures that are present in humans. The presence of these anatomical variations can affect nearby anatomical relations resulting in structural modifications. By the broad perspective of anatomical features in the sinonasal area, certain anatomical characteristics are supposed to be a risk factor for the advancement of sinus pathological conditions and hence it should be essential for the radiologist to be conscious of the variable anatomical structures residing within the nasal and PNS area, significantly if the treatment plan includes surgical procedures. The sinonasal tomographic imaging is required in symptomatic subjects of sinusitis to evaluate the mysterious sinonasal anatomy including morphology, variations, detailed bony visualization, and pathologies within the sinonasal region and surroundings. This review includes studies from 2013-2023 which were extracted from searching databases like Google Scholar, Internet sources, PubMed, Scopus, and Medline to establish a critical review of hidden anatomy of nasal and paranasal sinus region, detected by computed tomography and highlight the operative significance to enhance the surgical outcomes globally

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Anatomical aberration of palmaris longus agenesis muscle through clinical examination in relation to gender and hand dominance

Objective: To determine the frequency of agenesis of palmaris longus muscle and its association with gender and hand dominance. Method: The cross-sectional descriptive study was conducted at the Bahria University Medical and Dental College, Karachi, from March 2021 to November 2021, and comprised medical students of either gender from 1st, 2nd and 3rd year of studies. Clinical examination of palmaris longus was done by using the classic Schaeffer’s test, and it was confirmed using the Thompson’s test. The agenesis of palmaris longus muscle and its association with gender and hand dominance was also tested. Data was analysed using SPSS 23. Results: Of the 200 participants, 114(57%) were female and 86(43%) were male. The overall age range was 18-23 years. Of the total, 195(97.5%) subjects were right hand dominant and 5(2.5%) were left hand dominant. Agenesis was found in 67(33.5%) subjects with no significant difference in terms of gender or hand dominance (p>0.05). Statistically significant difference (p=0.01) was found related to bilateral agenesis. Conclusion: Bilateral agenesis was found significantly more in females compared to the males, while palmaris longus agenesis and hand dominance had no significant association. Key Words: Anatomical, Aberration, Palmaris longus, Agenesis, Clinical examination, Gender, Hand dominance