Honour Killings of Women in Punjab: A Socio-Political Context

This study examined the relationship between the violent practice of honour killing and the role of the socio-cultural institution, such as, the law-makers, i.e., politicians about the reinforcement of this customary practice. The qualitative method has been used to get the in-depth information about the subjective experiences and perceptions of various politicians. By employing purposive sampling comprising of five representatives from the law-makers, i.e., politicians who were working with the cases of the honour killings of women, data were taken from the largest province of Punjab. The Interpretative phenomenological approach (IPA) was used to analyze the semi-structured interviews of various participants. This study discussed the collusion of politicians with other functionaries, lack of effective law enforcement by the police force and the failure of the criminal justice system in combating the honour violence committed against women in Punjab. The resolution of the problem involves the change of mindset of all the associated stakeholders. Various measures have been advocated to address the honour crime through the execution of the relevant policy strategies and pertinent legislation

Radiation induced tumor lysis syndrome in patients with leukemia

Tumour lysis syndrome is a catastrophic complica­lion of treatment of certain neoplasms. It is usually seen with the tumours that have high growth fractions, increased bulk and extreme sensitivity to cytotoxic therapy. Most commonly it occurs in association with hematologic malignancies such as lymphomas and leukaemias. Rarely it has been observed with solid tumours like small cell lung cancer, seminoma and carcinoma of the breast. The syndrome develops due to massive cell lysis occurring within a few hours to a few days of starting the cytotoxic therapy. It is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcaemia. Acute renal failure, cardiac arrhyth­mias and sudden death may occur. Tumour lysis syndrome has hitherto not been reported as a complica­lion of radiotherapy only. We recently observed a patient with a diagnosis of chronic myeloid leukaemia who received splenic irradiation for massive splenomegaly and developed full-blown tumour lysis syndrome. Pathogenesis and clinical implications are discussed

Frequency of Hyperlipedemia in Patients Coming with Ischemic Stroke in Tertiary Care Hospital Karachi

Background and objective: Stroke is the second leading cause of death and the third leading cause of disability. This study was designed to determine the frequency of hyperlipidemia in patients with ischemic stroke visiting at a tertiary care hospital in Karachi. Methods:This was a descriptive cross-sectional study and was done in Department of Medicine, LCMD/ Dar-ul-Sehat Hospital Karachi, Pakistan. A total of 184 patients were studied during the study period of six months and all the consecutive patients were recruited who presented with acute stroke in the department of medicine from the duration April 1st 2022 to September 30th, 2022.Those fulfilling the inclusion criteria for this study were included for data analysis, while the patients who did not meet the said criteria were excluded. Their serum lipid levels were collected within 24 hours of admission. Hyperlipidemia was measured through fasting lipid profile and was labeled as present if any one or more of the following profile like total cholesterol \u3e200 mg/dl, LDL cholesterol \u3e 100 mg/dl, TGL \u3e 150 mg/dl, HDL cholesterol \u3c 40 mg/dl, as appropriate. Results:The mean age of the patients was 65.17±12.73. Average systolic and diastolic blood pressure was 152.34±21.31 & 83.35±13.71 mm Hg respectively. Mean duration of smoking and diabetes mellitus in first ever ischemic stroke patients was 9.33±4.03 & 13.65±5.8 years respectively, whereas average fasting blood sugar was found 151.98±69.73mg/dl; 118 (64%) were males and 66 (36%) were females. A total of 124 (67.4%) of patients had a history of hypertension, while 94 (51.1%) were diabetic. Fifty-three (28.8%) of patients had a history of coronary artery disease while 22 (11.95%) patients had history of smoking. Increased triglycerides level was seen in 47 (25. 5%). The frequency of hyperlipidemia was 145 (79%) patients respectively. Conclusion: Frequency of hyperlipidemia was 145 (79%) in patients with ischemic stroke which is moderately high in our setup. A high prevalence of hyperlipidemia is alarming in our setup and requires attention of the physicians on modifiable risk factors

A clinicopathological analysis of ovarian tumours

We performed a retrospective analysis of patients with ovarian tumors who were admitted to the Aga Khan University Hospital from January 1985 to December 1989. Sixty one cases were reviewed. Mean age of the whole group was 44 years. Majority of the patients presented with abdominal pain and distention. Most frequent physical finding was a palpable mass on pelvic or abdominal examination. Overall these patients had a higher incidence of breast cancer than expected in the general population. Two-thirds of the tumors were malignant. Comparison of the patients with malignancy against those with benign tumors failed to show any correlation with parity. Majority of the patients with malignant disease were above forty and had ultrasound showing a cystic mass over 10 cms in size. Cancer was mostly epithelial in origin, with widespread disease (stage III or IV) at the time of presentation. Benign tumors, mostly of germ cell type, were predominantly seen in patients under the age of forty with ultrasound showing cystic mass of any size from under 5 cms to over 10 cms

Breast Gangrene

<p>Abstract</p> <p>Background</p> <p>Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene.</p> <p>Methods</p> <p>A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed</p> <p>Results</p> <p>All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area.</p> <p>Conclusion</p> <p>Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.</p

Measuring Urban Sustainability through Compact City Approach: A Case Study of Lahore

Achieving urban sustainability has become a prime goal for urban planners. However due to its subjective nature, it is complicated to integrate urban sustainability concept in planning practices. Moreover, it is advocated that measure of urban sustainability through the compact city is a vital solution for city management. However, due to dynamic nature of the city structures around the world, there exists a limited consensus on parameters and dimensions to measure urban compactness especially in the towns developed in unplanned manners. This study aims to explore different dimensions and relevant indicators to understand and measure compactness in the context of Lahore. The findings of the research reflected that the key factors for the urban sustainability in a compact city are density, transportation and landuse. Density profile in Lahore shows that new residential schemes are rapidly occupying the vacant land and consequently increasing average trip distances and urban sprawl. Besides this, landuse breakup in Lahore is highly variant because of the rapid change in its uses. Average land consumption per person in Lahore is 51 square meter which is on the lower side and would have grave consequences for public rely on car use in future. Moreover, public transport accessibility in Lahore is another problem faced by the general public. Finally, it is concluded that Lahore is a compact city to some extent with the absence of sustainability concepts due to lack of regularity authority control and haphazard development. The situation needs immediate attention of authorities otherwise use of public transportation will be decline and cars will encroach major part of ones' land consumption

Evidence of chikungunya virus disease in Pakistan since 2015 with patients demonstrating involvement of the central nervous system

Several arboviruses are endemic to and co-circulate in Pakistan. In recent years, Pakistan has observed a rise in arboviral infections. A cross-sectional study for arboviral diseases, which included screening for Chikungunya virus (CHIKV), was initiated in 2015 to determine which pathogens were causing disease in patients presenting to health care services. Exposure to CHIKV was verified via detection of viral nucleic acids or virus-specific IgM with virus-specific neutralizing antibodies. Out of 997 enrolled patients presenting with clinical features suggestive of arboviral disease, 102 patients were positive for CHIKV IgM antibodies and 60 patients were positive for CHIKV nucleic acids or neutralizing antibodies. The data presented here show that CHIKV has been circulating in Pakistan since April of 2015. CHIKV infections were detected in study subjects up to the conclusion of our enrollment period in July 2017. Syndromic and clinical data show that arthralgia was associated with CHIKV as was rash, fever greater than 38°C, and lymphopenia. Neurological symptoms were reported in 49% of CHIKV suspect patients and in 46.6% of confirmed infections. Acute disseminated encephalomyelitis was diagnosed in 5% of confirmed infection and various manifestation of encephalitis diagnosed in an additional 16.6% of patients with confirmed CHIKV infections. CHIKV-exposed patients were just as likely to present with neurological symptoms and encephalitis as patients with West Nile Virus infections but were 4.57 times more likely to have lymphopenia. This proportion of neurological symptoms may be a complicating factor in countries where WNV and/or JEV co-circulate with CHIKV

Secondary Tuberculosis of Breast: Case Report

Tuberculosis of breast is a rare disease which is difficult to differentiate from carcinoma of breast. The involvement of breast can be primary or secondary to some focus in body. A case of secondary tuberculosis of right breast in a 21-year-old female from Kashmir, India, is being reported. Presentation was as a painless discharging sinus of right breast. A tubercular foci of rib was the affecting source of disease. No other evidence of tuberculosis was present in the body. Resection of involved rib segment, along with the discharging sinus, was performed. The patient had antitubercular therapy for 9 months, with no recurrence seen in followup

Gut Microbiome: A New Organ System in Body

The gut microbiome is comprised of various types of bacteria, fungi, protozoa, and viruses naturally occurring in humans and animals as normal microflora. Gut microorganisms are typically host specific, and their number and type vary according to different host species and environment. Gut microbes contribute directly and/or indirectly to various physiological processes including immune modulation, regulation of various neurotransmitter, and hormones, as well as production of many antioxidants and metabolites. They also play a role as antibiotic, anti-inflammatory, anti-diabetic, and anti-carcinogenic agents. Moreover, the ability of gut microbes to attenuate various systemic diseases like coronary heart disease, irritable bowel syndrome, metabolic diseases like diabetes mellitus, and infectious diseases like diarrhea has recently been reported. Current research findings have enough evidence to suggest that gut microbiome is a new organ system mainly due to the microorganisms’ specific biochemical interaction with their hosts and their systemic integration into the host biology. Investigations into the potential ability of gut microbiome to influence metabolism inside their host via biochemical interaction with antibiotics and other drugs has recently been initiated. This chapter specifically focuses on the importance of gut microorganisms as a new organ system