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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.

Objective: To determine the prevalence of H. pylori induced gastritis and its association with development of chronic inflammation and carcinoma with reference to updated Sydney classification, to ensure the proper diagnosis and timely treatment. Methods: This was a cross sectional study conducted at the Department of Pathology, Dow Diagnostic Reference and Research Laboratory for the year 2018. Analysis of about 726 gastric biopsy specimens was performed to identify the epidemiological status of the disease. On the other hand, 100 of the specimens were analysed according to Sydney classification to ensure the accurate diagnosis of the gastritis and related disorders. Out of 726 biopsy samples positive samples for carcinoma were investigated in detail histological features. Giemsa stain was used to visualize the h pylori bacteria and the sections of biopsies were subjected to haematoxylin and eosin staining for histological analysis. Results: Out of 727 cases, H. pylori was found in 492 (67.8%) patients. About 1.79% (13) cases were identified as adenocarcinoma, 0.27% (2) squamous cell carcinoma and 0.13% (1) as B cell non Hodgkin lymphoma. Results of Sydney classification. The degree of chronic inflammatory activity was 57% mild; 38% moderate and 3% severe out of a total of 67% cases in an active phase of Hp gastritis. Hp-associated gastritis was the most common form of chronic gastritis, without intestinal metaplasia and with mild activity. The association of h pylori with mild inflammation and Neutrophilic infiltrates of the lamina propria, pits, or surface epithelium was statistically significant (p value < 0.05). Conclusion: The frequency of H. pylori infection is common in our population but the infection is mild to moderate and its Sydney classification reveals that early diagnosis may prevent the later complication.

The genus Citrus of the family Rutaceae includes many species e.g. Citrus indica, Citrus aurantifolia and Citrus limon, among which Citrus limon L. Burm. f. has been reported to have highest antimicrobial activity. It is used as antidote against certain venom, due to its platelet inhibitory effect and also reported to have hypocholesterolemic effect. However its anticoagulant and thrombolytic effect were not been investigated, hence a prospective in-vitro/in-vivo study was designed to determine the effect of Citrus limon on blood parameters, coagulation and anticoagulation factors. In-vitro tests revealed highly significant increase in thrombin time and activated partial thromboplastin time by Citrus limon, whereas fibrinogen concentration was significantly reduced in comparison to control, however prothrombin time was not affected significantly. In-vivo testing of Citrus limon was done at three different doses i.e. 0.2ml/kg, 0.4ml/kg and 0.6ml/kg in healthy rabbits. Significant changes were observed in hematological parameters such as erythrocytes, hemoglobin and mean corpuscular hemoglobin concentration. Bleeding time and thrombin time was significantly prolonged and there was increase in protein C and thrombin antithrombin complex levels. These results may be due to inactivation of thrombin because it significantly decreases fibrinogen concentration and inhibit platelet aggregation. Citrus limon showed maximal anticoagulant effect at 0.4ml/kg, which suggest that Citrus limon possesses an anti-thrombin component and could prevent thrombosis playing a cardio protective role.