Journal of Islamabad Medical & Dental College

Establishing and Sustaining a Peadiatric Bone Marrow Transplant Program in Developing Countries

Aliya Batool, Sadaf Khalid — Wed, 19 Apr 2023 12:08:40 +0500

Clinicopathological Features and Expression of Ki-67 in Odontogenic Keratocyst, Dentigerous Cyst and Radicular Cyst

Wed, 19 Apr 2023 12:33:38 +0500

Background: Biological behaviour of Odontogenic Keratocyst (OKC) is aggressiveness than others Odontogenic Cysts (OCs) like Dentigerous Cyst (DCs) and Periapical Cyst/Residual Cysts (RCs). The aim of the study was to determine clinicopathological features and expression of Ki-67 in Odontogenic Cysts of the oral cavity.

Methodology: This cross-sectional study was conducted at de’Montmorency College of Dentistry (DCD from Feb, 2020 to Feb, 2022 after approval from Institutional Review Board (IRB) of DCD. A total 78 cases of OCs were collected from hospitals which are affiliated with the DCD. Routine lab process for Hematoxylin & Eosin and Immunohistochemistry was performed. Data entry and statistical analysis was carried out in SPSS 21. A Chi- square test was applied to observe the association between cyst and Ki-67. P value < 0.05 was taken as statistically significant.

Results: Among total 78 cases the mean age was 25.08 ±14.5 years with an age range of 6-70 years. Most OCs (64.1%) were reported in males than females (35.89%). Most OCs were reported in mandible (56.4%. Ki-67 expression in OKC was high 7.7%, low in 76.9% and negative in 15.4%). Most of the DCs and RCs expressed low expression of Ki-67 (84.6% and 76.9% respectively).

Conclusion: Most of the odontogenic cysts expressed low expression of Ki-67 while few cases of OKC and DC expressed high expression.

Keywords: Dentigerous Cyst, Odontogenic Keratocyst, Immunohistochemistry, Ki-67, Odontogenic Cysts, Periapical Cyst, Radicular Cyst.

Immunohistochemical Approach to the Study of Pulmonary Neuroendocrine Tumors

Wed, 19 Apr 2023 12:35:08 +0500

Background: Tumors that arise from neuroendocrine cells can present throughout the body, most commonly in the gastrointestinal tract and pulmonary systems. Neuroendocrine tumors (NETs) of the lungs account for about 25% of primary lung cancers, as well as 20–25% of primary NETs

Objective: To analyze the immune-histochemical aspects of Neuro-endocrine Tumors and apprise the reactivity of various immune-histochemical markers.

Methodology: This cross-sectional study was conducted in Pathology Department of Gulab Devi Hospital Lahore from January 2021 to December 2021. Total 112 patients with pulmonary NETs cases diagnosed with medical records patients data, clinical features and radiologic images were obtained and both genders with CT scan findings of lung mass were included in the study. Data was entered and analyzed in SPSS. Gender, diagnosis, techniques etc. were presented as frequency and percentage. Age was presented as mean and SD.

Results: The mean age was 45.2+12.1 years. The age range between 20 to 60 years. There were 96(86%) male and 16(14%) female. Typical carcinoid was prevailing in young age group while small cell neuro-endocrine tumor was dominant in older patients. Most of the samples were collected using bronchial biopsy 86(77%), 18(16%) of the samples were collected by CT guided biopsy while 7(6%) were collected by ultrasound guided biopsy and 1(1%) by surgical resection. Patients were diagnosed as small cell lung carcinoma 96(86%), typical carcinoid was the second most common diagnosis 10(9%), large cell lung carcinoma was 4(3.0%) and atypical carcinoid tumor was seen in 2(2%) in cases.

Conclusion: SCLC was found to be the predominant pulmonary NET. Chromogranin is less sensitive than synaptophysin, raised Ki67 and TTF1 demarcates SCLC from carcinoid particularly in minute biopsy with obscure morphology.

Key words Immunohistochemistry, Neuroendocrine carcinoma, Small cell lung carcinoma.

Evaluation of the Occlusal Contact between the Opposing Teeth and the Cusp of Carabelli in Maxillary Permanent First Molars in Patients Visiting Peshawar Dental College

Wed, 19 Apr 2023 12:37:05 +0500

Background: The Cusp of Carabelli is a small additional cusp which is situated on the mesiopalatal surface of first maxillary molars. This nonfunctional cusp comes in many forms including furrows, ridges or pits and is collectively known as the Carabelli trait

Objective: To evaluate the frequency of the occlusal contacts between the accessory cusp of Carabelli and the opposing arch tooth among both genders in patients attending the out-patients department of Peshawar Dental Hospital, Peshawar

Methodology: This descriptive cross-sectional study was conducted on 300 subjects visiting the OPD of Peshawar Dental Hospital from October 2022 to December 2022. The sample size was calculated using WHO formula N=p(100-p)z²/d² (Http://www.fao.orgThe age group selected for the participants was from 13-30 years. Consecutive sampling technique was used.). Articulating paper was used to assess the occlusal contacts caused by the cusp of Carabelli. The data were analyzed using SPSS version 20. Pearson’s chi square test was applied to analyze the data. P value of ≤ 0.05 was considered statistically significant.

Results: The results of the current study showed that 10.7% of the participants experienced occlusal contacts caused by the presence of their accessory cusp with the opposing arch tooth with no statistically significant difference between genders.

Conclusion: The cusp of Carabelli is the most prevailing variation found on the palatal aspect of mesiopalatal cusp of permanent maxillary first molars in a hospital-based inhabitants of Peshawar with rare occlusal contacts experienced by the patients.

Key words: Cusp of Carabelli, Maxillary permanent first molars, Occlusal contact.

Relationship of Maxillary Sinus and Maxillary First Molar Root Using Cone Beam Computed Tomography

Wed, 19 Apr 2023 12:40:33 +0500

Background: Cone beam CT (CBCT) is an advancement of conventional CT that uses a divergent pyramidal or conical X-ray beam for imaging the craniofacial complex. Studies on the maxillary sinus and its relationship with the roots present within its close proximity are mostly based on computed tomography imaging and rarely being based on cone-beam computed tomography (CBCT). This study aims to determine the relationship of maxillary sinus and the mesiobuccal root of maxillary first molar using cone beam computed tomography (CBCT).

Methods: The study was conducted in Armed Forces Institute of Dentistry (AFID) from Sept, 2019 to Feb, 2020. 142 CBCTs were studied in the duration of six months. The distance between the maxillary mesiobuccal root and floor of maxillary sinus was measured using the built in software. The data collected was analyzed using SPSS 23. p-value of <0.005 was considered significant.

Results: The mean distance was -0.85 mm ± 2.56 on left side and -0.74mm ± 2.40 on right side. There was no significant difference between left and right side. The correlation between age and left and right-side measurements was statistically significant, p-value 0.000.

Conclusion: The relationship of maxillary sinus and the mesiobuccal root of maxillary first molar is significant. The study shows that in dentate healthy patients, the maxillary mesiobuccal molar root is nearly in contact with the sinus floor. These findings lead to the conclusion that performing surgical procedures in maxillary molar region may invariably lead to sinus perforation if one is not care full.

Keywords: Cone beam computerized tomography, Dental implant, Maxillary sinus, Molar

Predictors of Relapse and Survival in Testicular Germ cell Tumors in Children

Wed, 19 Apr 2023 13:04:39 +0500

Background: Testicular germ cell tumors are common solid organ malignancies in children with a survival rate of more than 90 %. This study aims to assess the predictors of relapse and survival in testicular germ cell tumors in children.

Methodology: A retrospective review was conducted on children up to the age of 18-years from January 2010 to December 2020 with a diagnosis of primary testicular germ cell tumors. Factors related to relapse and survival like age, baseline levels of tumor markers in serum and on relapse, stage at diagnosis, histological type, tumor laterality & size of the tumor in testicular germ cell tumors were analyzed. The data was entered into SPSS version 20. Statistical significance was set at a p-value ≤0.05.

Results: A total of 115 patients with a mean age of 5.42+ 1.54 years having testicular germ cell tumor were treated. Seventeen patients (14.7 %) had relapse of disease. Relapse was highest in patients with stage I disease (64.7 %). Yolk sac tumor was the most common pathology that was noted in twelve (70 %) patients. The most common site of relapse was the retroperitoneum (70 %). Age of patient, stage of disease, and lymphovascular invasion were significant predictors of relapse and survival in testicular germ cell tumors.

Conclusion: Management of patients with testicular germ cell tumors requires standardized follow-up protocol for early detection and treatment of disease relapse. Complete surgical excision with meticulous control of the residual disease is critical to prevent disease relapse.

Keywords: Chemotherapy, Children, Outcome, Relapse, Testicular Tumor

Frequency of Gallstones in Fatty Liver disease in a Tertiary Care of Suburban Islamabad

Wed, 19 Apr 2023 13:05:23 +0500

Background: Gallstone disease and Non-Alcoholic Fatty Liver Disease (NAFLD) share common etiological pathways. The objective of this study was to determine the frequency of Gallstones and Non-Alcoholic Fatty Liver disease (NAFLD) in patients undergoing abdominal ultrasounds in our hospital and to compare the frequency of Gallstone disease in patients with NAFLD and without NAFLD.

Methodology: This cross-sectional study was carried out at HBS General Hospital, Islamabad from January 2020 till December 2020. Patients undergoing routine ultrasounds in the out-patient department of the hospital were included in the study. Patients having Emergency Ultrasounds, history of Alcohol intake, history of chronic liver disease and pregnant patients were excluded from the study. Data was analysed using Microsoft Excel 2016 and IBM SPSS 22.

Results: A total of 689 patients were included with a 3:1 Female to Male ratio. Mean Age was 40.65± 15.610 years. The prevalence of Gallstone disease was found to be 20.9% while that of NAFLD 27.6%. A higher percentage of patients with NAFLD had Gallstones as compared to those who did not have NAFLD (24.2% vs 19.6% respectively) however for overall data, statistical significance was not reached. A statistically significant greater number of young patients with NAFLD had Gallstones as compared to those who did not have NAFLD (50% vs 6%, p<0.001). Mean age was greater in patients who had NAFLD as well as those having Gallstones.

Conclusion: The frequency of Gallstones was greater in patients with NAFLD as compared to those without NAFLD.

Keywords: Cholelithiasis, Fatty Liver Disease, Gallstones, Non-Alcoholic, Ultrasonogram

Medicolegal Aspect Analysis of Burn Cases in Liaquat University Hospital, Hyderabad

Wed, 19 Apr 2023 13:05:56 +0500

Background: Owing to the high potential of physical injuries, disabilities and even deaths resulting from burn-related injuries, these are considered as injuries of medico-legal importance. The study aims to investigate the medico-legal aspects of selective cases of burn victims admitted to the Burn unit of Liaquat University Hospital, Hyderabad.

Methodology: This study was conducted at the Burn unit of Liaquat University Hospital, Hyderabad. The information on burn patients was collected retrospectively from the record for the period of three years from January 2018 to December 2020 from the Burn unit. The data related to socio-demographic details, site, cause, severity and outcome of burn cases was recorded.

Results: Total 418 victims record was evaluated; the highest prevalence of cases was in the age group of 0-10 years (60.6%). Majority; 58.8% of the victims were males. In more than half (52.6%) of the victims, 20% or less body area was burnt. In 34.2% cases, 21-40% area was burnt. About 48.1% of cases were of wet scalds and 40.2% dry flame burns. About 7.6% were cases of electrocution. Male and female burn victims demonstrated statistically significant difference (p<0.05) regarding site of burn, side, source, manner and survival from burn injuries.

Conclusion: Males are more affected by burns than their counterpart while children ≤ 10 years are most commonly reported with burn injuries. Wet scald is the most common type of burn while most victims present with ≤20% burnt body area.

Key Words: Accidental injuries, Burns, Suicide

Factors Associated with Nurses’ Attitude towards Patient Safety Culture in an International Accredited Tertiary Care Hospital, Islamabad

Raisa Kausar, Kholood Janjua, Mainmoona Siddique, Gideon Victor — Wed, 19 Apr 2023 13:06:24 +0500

Background: Patient safety has emerged as a prime agenda over the past few decades to deliver safe care in increasingly complex service delivery. This study was set out to measure the factors associated with the safety attitudes of nurses.

Methodology: This descriptive cross-sectional research was conducted from May 2017 to June 2018 in Shifa International Hospital, Islamabad. Nurses were invited to participate in the study. The safety attitude questionnaire was used for data collection. Data were analyzed using SPSS v23.0.

Results: The response rate was 86%. Job satisfaction was high at 78.37±23.63 while stress recognition was low at 53.18±27.68. Nurses liked their job being a nurse 79.92±28.01 and workplace conditions 80.33±26.44. Whereas, hostile situations 48.92±34.95, the negative effect of fatigue 48.50±35.32, being held back to report patient problems 47.58±34.76 and discuss errors 45.42±34.79 were also highlighted. Safety attitudes were statistically significant high among intensive care nurses (P-Value < 0.05). Safety scores of nurses with longer job duration were high than those with lesser job duration. Teamwork was favorably correlated with safety climate, job satisfaction, perception of management, and working conditions (R > .466, P-Value < .01).

Conclusion: There was a positive attitude of nurses toward patients’ safety with some areas of improvement.

Keywords: Attitude, Nurse, Patient safety, Practice

Middle Ear Embryonal Rhabdomyosarcoma in a Five Years Old Child - A Rare Case Report

Nosheen Nabi — Wed, 19 Apr 2023 13:07:17 +0500

Rhabdomyosarcoma is the most common pediatric malignancy with a predilection for head and neck region. Embryonal Rhabdomyosarcoma is a variant of rhabdomyosarcoma which is extremely rare in middle ear. We present a case of middle year embryonal rhabdomyosarcoma in a five-year-old child who was treated as otitis media on first presentation and later misdiagnosed as a vascular aural polyp on histopathology.

Large gallbladder Removed by Laparoscopic Cholecystectomy A Case report

Muneeb Ullah; Muhammad Faisal Murad — Wed, 19 Apr 2023 13:08:00 +0500

Gallbladder stones impacted at neck of gallbladder can result in acute calculous cholecystitis with mucocele gallbladder. Laparoscopic cholecystectomy is performed in such cases as an emergency surgery. We present a case long gallbladder with mucocele formation that was managed by laparoscopic approach. The gallbladder removed was 27.8cm in length. This is the longest gallbladder removed by laparoscopic cholecystectomy in Pakistan so far. The patient had uneventful recovery.

Multiple Inflammatory Fibroid Polyps in a Female; A case Report

AYESHA IFTIKHAR — Wed, 19 Apr 2023 13:09:21 +0500

The inflammatory fibroid polyp (IFP) usually presents as a solitary benign polyp that arises from the submucosa of the gastrointestinal tract. It occurs more commonly in males and stomach is the favored site followed by ileum, colon and duodenum. Multiple inflammatory fibroid polyps (IFPs) is a rare occurrence, so we thought of presenting a case of a 40 years old female with multiple inflammatory fibroid polyps (IFPs). She presented with abdominal pain and abdominal fullness. Her C.T. abdomen showed multiple lobulated soft tissue masses causing intussusception. Surgical resection was done, and histopathological examination of these polyps showed features of IFPs. A literature review of 9 cases (including ours) between 2000-2022 is also presented. To our knowledge this is the third female patient with multiple IFPs.