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Introduction: In this period of advancement, forensic dentistry plays crucial role in recognition of a person for ethical and the legal proceedings through the analysis of orofacial and dental characteristics with previous records. In this study, we aimed to assess the interest of dental professionals in participating in forensic dentistry courses and their willingness to introduce this subspecialty in the course curriculum of post graduate studies and to assess the knowledge, attitude and awareness about forensic odontology among dental professionals of Karachi, Pakistan. Methodology: This cross-sectional study was conducted through an online self-administered Knowledge, Attitude, and Practices (KAP) questionnaire with multiple close-end questions. In a convenient sample of 277 participants that includes academic faculty, undergraduates, postgraduates, house officers, dental care professional students (DCP) and dental technician/hygienist from Karachi, Pakistan. Data was measured using IBM SPSS version 26.0. Results: The survey showed that a significant number of study participants have knowledge of forensic dentistry as a branch 70.02% (p value 0.000) of the respondents showed interest to integrate forensic dentistry in the core curriculum. 62% of the Participants showed willingness to opt forensic dentistry as a career or profession. Those who were unwilling had various reasons. A significant number of people maintain dental records (P value = 0.026). Conclusion: There is need for up gradation and recognition of forensic dentistry into the curricula of dentistry to meet the international trends and pursue it as career.

Background The classification of gliomas is changing profoundly and has been shifted from histological criteria only; to morphological and molecular markers. The routine everyday approach nowadays for diagnosing diffuse gliomas begins with immunohistochemistry (IHC) for IDH1, ATRX, and p53, as these substitute molecular testing for classification. Moreover, the Ki-67 immunomarker is a useful accessory marker for the proliferative activity and hence grading of these tumors. Keeping in mind the growing importance of molecular information in CNS tumor classification and the use of integrated diagnosis according to the new WHO Classification we undertook this immunohistochemical study for the integrated diagnosis of adult diffuse gliomas in our setup. Material & Method In this study, 92 prospective cases of adult diffuse gliomas were included from January 2018 to June 2021. We analyzed the IDH1, ATRX, and p53 status by immunohistochemistry (IHC) and analyzed the results in correlation to histological type, grade, and among these molecular markers. Result IDH R132H mutation, ATRX loss, and p53 mutation were mostly accompanied by astrocytoma in the current study. For IDH gene mutation, grade 2 and 3 patients (80%) have a higher positive rate than grade 4 (20%); for P53 gene mutation, grade 2 and 3 patients (77%) have a higher positive rate than grade 4 (22.6%). ATRX loss in astrocytomas was strongly associated with IDH1-R132H (p = 0.001) and p53 (p = 0.000). Among 31 glial tumors with nuclear ATRX loss, 23 (74%) had an IDH1 mutation and 19 (61%) had a p53 mutation. Ki-67 labeling index (LI) was above 5% in more than 90% of high-grade gliomas histologically and is associated with increasing WHO grade (p =

Aim: Head and neck cancers, all over the world, contribute greatly to the number of deaths, despite the advancements in the therapeutic strategies. It is characterized by locoregional disease with a tendency for metastasis to the cervical lymph nodes. The pre-operative detection of lymph node metastasis is critical for the effective treatment of patients with head and neck squamous cell carcinoma. Therefore the objective of this study was to identify E-cadherin as a marker for prediction of lymph node metastasis in head and neck squamous cell carcinoma (HNSCC). Study Design: Cross-sectional study. Place and Duration of Study: Dow University of Health Sciences, Karachi. 1 Year duration. Methodology: Cross-sectional analysis of 54 subjects with HNSCC, who underwent neck dissections, was carried out. Expression of E-cadherin was evaluated using immunohistochemical analysis and traditional histological parameters, and correlation of E-Cadherin with histologically verified presence of regional metastases was determined. Data was subjected to descriptive statistics and chi-square using Spss v.16.0. Results: 54 patients included 33 males (61.1%) and 21 females (38.9%) aged from 18 to 73 (mean 44.8±12.7). A statistically significant relationship between the Downregulation of E-cadherin and histologically verified presence of nodal metastasis was established. (p value= 0.01). Conclusion: This study shows that low E-cadherin expression is useful for predicting lymph node metastases in cases of head and neck carcinoma.

The in vivo hepatoprotective potential of methanolic extract of Ceasalpinia bonduc (CBLM) has been explored against carbon tetrachloride (CCl

Background: The esophagus is exposed to various factors being on the beginning of the gastrointestinal tract. Pathologies of esophagus vary from epithelial erosions to deep muscular involvement and from mild inflammation to cancers. Objective: To determine the risk factors like gender, smoking and gastro esophageal reflux disease for esophageal adenocarcinoma. Methodology: This comparative cross sectional study was carried out at Pathology department of Al-Tibri Medical College and Dow University of Health Sciences, Karachi, fromApril to September, 2018. After ERC approval 88 human subjects were selected through non-probability sampling using inclusion and exclusion criteria 22 subjects as controls (group-I) and 22 individuals withBarrett’s esophagus (Group-II), 22 patients with dysplasia(Group-III) and 22 known patients of esophageal adenocarcinoma (Group-IV). Risk factors like age, gender involvement, smoking and gastroesophageal reflux disease (GERD) were evaluated among these groups in terms of frequency and percentage, mean and standard deviation. Results: Overall males were 70 (79.55%) and females were 18(21.45%), similar fractions were observed as smokers and non-smokers and GERD but age ranged different in different study groups and 40 (45.54%) belonged to age range of 51-60 years. Mean age was 43±6, 56±2, 61±4 and 63±3 years, for groups I, II, III and IV respectively (p=0.00). Sex (p=0.1) and smoking (p=0.3) were not significantly associated with esophageal adenocarcinoma whereas, age (p=0.00) and GERD status (p=0.00) were significantly associated with esophageal adenocarcinoma in this study. Conclusion: We found that age, gastroesophageal reflux disease were significantly associated with development of adenocarcinoma of esophagus in our study.

Ethanopharmacological relevance Opuntia dillenii Haw (Nagphana) traditionally used against inflammation. The present study addressed the anti-inflammatory activity of O. dillenii derived methanol extract, fractions and pure compounds and their underlying mechanism of action. Materials and methods O. dillenii cladode methanol extract was subjected to vacuum liquid chromatography (VLC) furnishing two main fractions viz (T-1 and -2) leading to isolation of opuntiol (aglycone) and opuntioside ( O -glucoside), respectively. Anti-inflammatory activity of extract, fractions, pure compounds and reference drugs were evaluated using: (1) arachidonic acid (AA) and 12- O -tetradecanoyl-phorbol-13-acetate (TPA)-induced ear edema accompanied by histological studies of mice ear sections and phospholipase A 2 (PLA 2 )-induced mice paw edema. (2) Carrageenan and glycogen-induced peritonitis in rodents. In parallel levels of leukotriene B 4 (LTB 4 ) and reactive oxygen species (ROS) were also determined via HPLC and fluoroemetrically using 2′, 7′-dichlorodihydrofluorescein diacetate (DCFH-DA) dye, respectively. Additionally, levels of prostaglandin E 2 (PGE 2 ), tumor necrosis factor (TNF-α), interleukins IL-1β and -6 were measured by ELISA assay. Results O. dillenii methanol extract, fractions and pure compounds reduced AA and TPA-induced ear punch weight in a dose dependent fashion. The corresponding IC 50 values obtained also suppressed inflammatory features observed histologically. Furthermore, paw edema and peritonitis were also attenuated. Similar to indomethacin and diclofenac sodium, opuntioside reduced PGE 2 levels of inflamed ear which was comparatively 1.3× better than opuntiol. However, opuntiol was more potent in reducing LTB 4 levels in rat neutrophils with an IC 50 value of 19±3.3 μΜ, while opuntioside was ineffective. Opuntiol also effectively suppressed ROS (37%) and cytokine levels (TNF-α, IL-1β and -6) by ~50% and comparable to dexamethasone. Conclusions O. dillenii cladodes possess anti-inflammatory properties via inhibition of arachidonic acid metabolites and cytokines. Opuntiol (aglycone) emerged as a dual inhibitor of cyclooxygenase (COX) and lipooxygenase (LOX) pathways. It also suppressed ROS and cytokine levels. However, opuntioside manifested its selectivity towards COX (PGE 2 ) pathway without affecting LTB 4 levels. The present report describing the anti-inflammatory activity of opuntiol and opuntioside for the first time thereby, supporting and justifying the traditional use of O. dillenii against inflammation and may serve as lead compound in designing of new anti-inflammatory agents.

Objectives: To investigate immune cell densities in pre-neoplastic (DCIS), cancer (IDC) and control breast tissues. Methods: A total of four preneoplastic, 104 cancer and 104 control samples were analyzed. Morphological classification and prognostic scoring along with quantification of immune cells/mm2 was performed. Data were entered and analyzed using SPSS version 16. Correlation of immune cell densities with various tumour sub-types was investigated using paired t-test and ANOVA. A p-value of 0.05). Conclusion: Leukocytes may play a role in early stages of breast carcinogenesis.

Introduction: Ovarian neoplasm’s are an important cause of morbidity and mortality in women. Frozen section is widely used in the intra-operative assessment of patients with ovarian tumors to provide guidance for an appropriate surgical management. It is crucial to know intra-operatively, the exact nature of the tumor to determine the extent of surgery. It is in these situations where the Intraoperative frozen section technique plays its role in making this distinction. Methodology: Females of all ages undergoing planned surgeries for ovarian tumors at Aga Khan Hospital or outside referrals with request for intra operative diagnosis was included. Age of the patient, duration of the lesion and clinical impression were recorded and frozen section was performed. Results: Thirty four cases of ovarian tumors received for frozen section were included in this study. The calculated sensitivity was94.4%, specificity was 93.8%, positive predictive value was 94.4% and negative predictive value was 93.8%. Conclusion: This study shows that frozen section is a highly sensitive and specific method for the rapid diagnosis of ovarian tumors. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10798 Asian Journal of Medical Sciences Vol.6(1) 2015 77-80

To evaluate the relationship between serum anti-Mullerian hormone and follicular dynamics in mice.This experimental study was conducted in November, 2014 at the Dow University of Health Sciences, Karachi, and comprised laboratory-bred albino mice. They were sacrifised under anaesthesia and blood was collected via cardiac puncture to assess anti-Mullerian hormone while ovaries were collected for morphometric analyses. SPSS 19 was used for data analysis.There were 20 mice with a mean weight of 25±1.89 grams, while weight of the ovaries obtained from these mice was 9.6±0.92mg. The mean serum anti-Mullerian hormone was 29.89±9.7ng/ml. On average, there were 87.8+13.54 primordial follicles, 51.85±8.36 primary, 20.35±5.57 secondary, 11.30±3.38 early antral and 3.05 ± 1.27 late antral follciles (p0.001; p=0.06)..Association of anti-Mullerian hormone with follicle dynamics reflected its role as a true ovarian reserve marker. Its assessment was of great significance in infertile women as well as young patients receiving chemotherapy.

National level population-based cancer data have never been published from Pakistan in seven decades since independence (1947). Therefore, generation of high-quality regional data becomes highly relevant. Cancer data for the period of 2010-2015 representing the population from all districts of Karachi (14.6 million) are presented herein. After institutional approval (Ref no. IRB-459/DUHS/-14), a Pathology based cancer registry was established at the largest government-run diagnostic and reference center of Karachi. During 2010-2015, a total of 13,508 cancers (including 686 non-melanoma-skin-cancers (NMSC)) were diagnosed. Of these, 5665 (41.9%) were in males while 7843 (58.1%) were in females. Incidence rates for all cancers (excluding NMSC) were 66.7 per 100,000 (crude) and 105.1 per 100,000 (ASR) for males and 112.0 per 100,000 (crude) and 175.8 per 100,000 (ASR) for females. In males, cancer of lip and oral cavity was the most frequently diagnosed cancer (30.8%, ASR 33.1), followed by NMSC (7.7%, ASR 9.5) and colorectum (7%, ASR 7.3). In females, breast cancer was the most frequently recorded malignancy (49.5%, ASR 87.9), followed by lip and oral cavity (11.2%, ASR 22.0) and oesophagus (5.6%, ASR 10.7). We report that Karachi has the highest incidence of cancers of breast, lip and oral cavity, oesophagus and larynx in females and cancer of lip and oral cavity and larynx (2nd only to Turkey) in males compared to any of the Asian populations. Notably, incidence of tobacco associated cancers is very high in Karachi, demanding urgent attention by relevant authorities to address the un-controlled and drastically high consumption of various forms of tobacco in the city.

To analyze the frequencies of histological types of lymphoma, diagnosed with complete immunohistochemical profile in younger and older age group.Cross-sectional analytical study.Dow Diagnostic Research and Reference Laboratory, Dow University of Health Sciences, Karachi, from January 2009 to September 2013.Consecutive cases of lymphomas, which were diagnosed using immunohistochemistry, were analyzed according to WHO classification. Frequency and percentages for different types of lymphomas were calculated. Hodgkin and non-Hodgkin lymphomas characteristics in two age groups of less than and more than 40 years were compared, applying chi-square test.Out of the 318 cases, 79 (25%) were Hodgkin Lymphomas (HL) and 239 (75%) were Non-Hodgkin Lymphomas (NHL). Mixed Cellularity Hodgkin Lymphoma (MCHL) was the commonest (n=48). Amongst the NHL, 215 (89.95%) were B cell lymphomas and 24 (10.05%) were T-cell lymphomas. Diffuse Large B-Cell Lymphoma (DLBCL) was the commonest lymphoma (n=165, 69.95% of NHL). Anaplastic T-Cell Lymphoma (ALCL, n=10) was the commonest T-cell lymphoma. The frequency of HLwas significantly higher in the younger age group and that of NHLwas higher in the older age group (p0.001). Primary lymph node involvement was reported in 175 (55%) and cervical lymph node was the most frequent site. Extra nodal involvement was seen in 93 (29%) of all cases and was reported in 87 (36.4%) of NHLand 6 (7.5%) of HL. The most common extra nodal site was the gastrointestinal tract.Hodgkin lymphoma comprises 25% and non-Hodgkin lymphoma comprises 75% of all lymphomas. Both occur in younger age groups than reported in the West. B-cell NHLis three times more common than T-cell lymphoma. DLBCLis the most frequent lymphoma. ALCLis the most common T-cell, and mixed cellularity is the most common Hodgkin lymphoma.