Peshawar Medical College Research Articles

Expression of CD3 Levels of Tumor Infiltrating Lymphocytes (TILs) in Various Grades of Oral Squamous Cell Carcinoma of Tertiary Care Hospitals of Peshawar

Introduction: The diagnosis of oral squamous cell carcinoma occurs late in the disease. Poor prognosis of the patient is directly correlated with the occurrence of metastatic lesions. Lymphocytes that have invaded tumors significantly influence how well cancers respond to treatment. Objectives: The objective of the study was to compare the immunohistochemical expression of CD3 TILs receptor in various grades of oral squamous cell carcinoma. Materials and Methods: This study was a retrospective comparative cross sectional (Analytical) study. It was conducted at Department of Pathology, Peshawar Medical College from August 2020 to August 2021. Sample size was calculated through G Power and 104 patients were included in the study. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0. Chi Square test was performed for categorical variables. Results: It was observed in our study that the mean age of OSCC was 59.16 ± 13.549 SD. Half of the cases were > 60 years (n= 52, 50%) and half of the cases were < 60 years (n= 52, 50%). The male to female ratio was approximately 2:1. The most common site involved by OSCC was buccal mucosa (n=39, 37.5 %) followed by tongue (n = 31, 29.8 %). Most OSCC were well differentiated (n=54, 51.9%), followed by moderately differentiated cases (n=29, 27.9%) and poorly differentiated (n=21 cases, 20.2 %). The p value hence showed a significant difference for intratumoral and intrastromal CD3 TILs expression and grades of OSCC cases (P- value <0.0001). Conclusion: Well-differentiated oral squamous cell carcinoma has the highest CD3 TILs level, followed by moderately and poorly differentiated OSCC. Keywords: Tumor Infiltrating Lymphocytes, Tumor Microenvironment, CD3, Immunohistochemistry

Expression of P16 in Various Grades of Oral Squamous Cell Carcinoma of Tertiary Care Hospitals of Peshawar

Introduction: Oral squamous carcinoma (OSCC) is one of the ten most common carcinomas in the world. The survival rate of OSSC is poor due to its diagnosis at advanced stages, The main function of p16 in the body is to halt the tumor process, but genetic mutation may result in the development of OSCC. Objectives: The aim and objective was to compare the immunohistochemical expression of p16 in various grades of oral squamous cell carcinoma. Materials and Methods: This study was a retrospective comparative cross-sectional (Analytical) study. It was conducted at the Department of Pathology, Peshawar Medical College from August 2020 to August 2021. The sample size was calculated through G Power and 103 patients were included in the study. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0. Chi-Square test was performed for categorical variables. Results: It was observed in our study that the mean age of OSCC was 59.16 ± 13 SD. The commonest effected age was 61-70 years (29%). The male to female ratio was approximately 1.2:1. The most common site involved by OSCC was buccal mucosa (n=49, 47%) followed by the tongue (n = 29, 29%). The p16 expression was positive in most OSCC were well differentiated (n=50, 92.5%), followed by moderately differentiated cases (n=26, 92.8%) and poorly differentiated (n=81, cases, 85.7%). There was no significant difference for p16 expression and grades of OSCC cases (P- value =0.601). Conclusion: The expression of p16 was more common in Well-differentiated oral squamous cell carcinoma, followed by moderately and poorly differentiated OSCC. Keywords: Oral Squamous cell carcinoma, P16, Human Papillomavirus

Cheiloscopy: A Study of Most Common Morphological Patterns of Lip Prints Among Male Students and Employees of Peshawar Medical College

Objective: To determine the frequency of most common morphological patterns of lip prints among male students and employees of Peshawar Medical College. Design: It was a cross-sectional study. Study Settings: This study was conducted at Forensic Medicine Laboratory of Peshawar Medical College from November 2021 to April 2022. Material and Methods: A total of 201 male voluntary participants both students and employees were included in the study. Lip prints were be obtained from them using lipstick and cellophane tape, and studied in the presence of lip print expert. The lip print patterns were classified and frequencies determined. Results: Overall pattern, type V (26.62%) and type III (19.58%) were the most common ones. There was no significant difference between the ethnicity. Conclusion: It might be said that lip prints are distinctive, and that using them to identify people. The results showed that print of any two lips were not matched exactly. The patterns did not reveal any significant variability with regards to gender or ethnicity. Thus, trivializing the concept that lip prints can be used as a good indicator for gender determination. Keywords: Lip Prints, Classification, Pattern Types, Cheiloscopy

Predominant Lip Print Pattern Found among Female Students and Employees of Peshawar Medical College

Objective: The objective of this study is to determine the predominant lip print pattern found among female students and employees of Peshawar medical college. Design: It was a cross-sectional study. Study Settings: This study was conducted at Forensic Medicine Laboratory of Peshawar Medical College from November 2021 to April 2022. Material and Methods: A total of 107 (74 females, and 33 employees) voluntary participants both students and employees were included in the study. Lip prints were be obtained from them using lipstick and cellophane tape, and studied in the presence of lip print expert. The lip print patterns were classified and frequencies determined. Results: Overall pattern, type V (26.62%) and type III (19.58%) were the most common ones. There was no significant difference between the ethnicity. Conclusion: It might be said that lip prints are distinctive, and that using them to identify people. The results showed that print of any two lips were not matched exactly. The patterns did not reveal any significant variability with regards to gender or ethnicity. Keywords: Lip Prints, Classification, Pattern Types, Cheiloscopy

ASSOCIATION OF THYROID HORMONE LEVELS WITH LUTEAL PHASE DEFICIENCY IN INFERTILE WOMEN

Objectives: To find out the association of thyroid hormone levels with Luteal Phase Deficiency (LPD) Methodology: This prospective study was conducted at Peshawar Medical College, from April to August 2013. The sample size was 125 infertile women of the reproductive age group (18-42 years) selected through consecutive sampling technique. On the 22nd and 23rd of the menstrual cycle, endometrial biopsies were performed. Chemilu­minescence Immunoassay was used to estimate the serum levels of the thyroid hormones. SPSS version 19 was used to conduct the statistical analysis. The Chi-square test was used to see whether there was any statistically significant difference between the endometrial findings of patients with normal thyroid profiles and those who had elevated thyroid hormone levels. It was deemed statistically significant when the probability value was p<0.05. Results: The majority of infertile patients (n=99) had normal thyroid profiles, followed by hyperthyroid cases (n=23). Only three turned out to be hypothyroid. There was no significant difference in endometrium between the patients with normal and increased thyroid hormone levels. Conclusion: Although no statistically significant association between the thyroid hormones levels and the endo­metrium in cases of Luteal Phase Deficiency could be found in this study, their role cannot be ignored and needs further evaluation

SOX10 EXPRESSION IN SELECTIVE MALIGNANT SALIVARY GLAND TUMORS OF INTERCALATED AND EXCRETORY DUCTAL ORIGIN

Objective: To determine the level of immunohistochemical expression of SOX10 in malignant tumors of salivary gland of intercalated ductal and excretory ductal origin. Material and Methods: An analytical cross-sectional study was designed. Sample size was 90 and categorised into two groups i.e., intercalated ductal (adenoid cystic carcinoma AdCC and polymorphous low-grade adenocarcinoma PLGA) and excretory ductal (mucoepidermoid carcinoma MEC). Blocks were retrieved from the histopathology lab of Pakistan Institute of Medical Sciences (PIMS), Peshawar Medical College (PMC) and Islamabad Diagnostic Center (IDC) from 2015 – 2020. Hematoxylin & Eosin (H&E) and Immunohistochemistry (IHC) slides were prepared and examined under microscope. Statistical analysis was done using SPSS version 25. Results: The intensity was found weak in 24 (85.7%) and moderate 4 (14.3%) in excretory ductal tumors. Similarly, the intensity was strong and intense in most of the intercalated ductal tumors compared to none in the excretory ductal tumors. The difference was statistically highly significant (p-value,<0.001). Similarly, the proportion of SOX10 was found with no positive cells in 25 (89.3%) and <10% cells in 3 (10.7%) cases of excretory ductal tumors whereas in the intercalated ductal tumor cases almost two third (62.8%) patients had cells between 51- 80% and above 80%. The difference in proportion of SOX10 was found statistically significant (p-value, <0.001). Conclusion: The conclusion of this study is that immunohistochemical expression of SOX10 can help in differentiating the origin of tumors of intercalated ductal and excretory ductal origin. Key Words: Adenoid cystic carcinoma, Polymorphous low-grade adenocarcinoma, Mucoepidermoid carcinoma, SOX1O, Immunohistochemistry, Hematoxylin & eosin.

TERATOGENIC EFFECTS OF TOPICALLY APPLIED PARAPHENYLENEDIAMINE ON THE RAT FOETUS

Background: Paraphenylenediamine (PPD) is an organic compound used in hair dye. It causes local and systemic side-effects. Not much is known regarding its foetotoxic effects. This study aimed at determining the teratogenic effects of topically applied PPD. Methods: This experimental study was carried out at IBMS, Khyber Medical University, and Peshawar Medical College, Peshawar over a period of 6 months. Twenty healthy Sprague Dawely female pregnant rats were divided into 5 groups, i.e., positive control (Group A), control (Group B), and 3 experimental groups (C, D, and E). For group A, 0.1 ml of distilled water was applied topically on back of each rat. For positive control group B, 0.5 ml of dye containing 3% PPD was applied, while for group C, D and E, 1, 2 and 3 mg/Kg dose of PPD respectively was applied for 30 minutes daily. Skin was washed followed by rats mating. After successful fertilization, same doses were repeated for 20 days. Animals were sacrificed and foetuses were examined for skeletal abnormalities and hepatic changes. Skin biopsy of adult rats was examined for any changes. Result: Topically applied PPD resulted in significant teratogenic effects on foetal liver in a dose dependent manner. However, no significant teratogenic effect was observed on foetal skeleton (p=0.075). Topical PPD showed increased epidermal thickening and keratinization on adult rats skin. Conclusion: PPD has significant dermal effects on adult rats and teratogenic effects on liver of rat foetuses but no significant effects were observed on foetal skeleton. Pak J Physiol 2022;18(2):15?21

Incidence of SARS-CoV-2 re-infection in anti-nucleocapsid IgG-positive healthcare workers: a prospective cohort study.

Background Since the pandemic of SARS-CoV-2 began, our understanding of the pathogenesis and immune responses to this virus has continued to evolve. It has been shown that this infection produces natural detectable immune responses in many cases. However, the duration and durability of immunity and its effect on the severity of the illness are still under investigation. Moreover, the protective effects of antibodies against new SARS-CoV-2 variants still remain unclear.ObjectivesTo assess the incidence and associated demographic features of SARS-CoV-2 infection in anti-nucleocapsid IgG-positive and anti-nucleocapsid IgG-negative healthcare workers.Material and methodsThis prospective longitudinal cohort study was conducted in Peshawar Medical College group of hospitals of Prime Foundation. Anti-nucleocapsid IgG sero-positive and anti-nucleocapsid IgG sero-negative healthcare workers were followed for a period of 6 months (from 1 Aug 2020 to 31 Jan 2021), and the incidence of SARS-CoV-2 was confirmed by RT-PCR.ResultsA total number of 555 cohorts were followed for a period of 6 months; of them 365 (65.7%) were anti-nucleocapsid-negative (group A) and 190 (34.3%) were anti-nucleocapsid-positive (group B) healthcare workers. The mean age of the study cohort was 33.85 ± 9.80 (anti-N (–), 34.2 ± 10.58; anti-N ( +), 33.5 ± 9.50). The median antibody level in anti-nucleocapsid-positive HCWs was 15.95 (IQR: 5.24–53.4). Male gender was the majority in both groups (group A, 246 (67%), group B, 143 (48%)) with statistically significant difference (P < 0.05). Majority of the HCWs were blood group B in both groups (34% each). None of the 190 anti-nucleocapsid-positive HCWs developed subsequent SARS-CoV-2 re-infection, while 17% (n = 65) HCWs developed infection in anti-nucleocapsid-negative group during the 6-month follow-up period.ConclusionIn conclusion, none of the anti-nucleocapsid-positive HCWs developed SARS-CoV-2 re-infection in this study, and the presence of IgG anti-nucleocapsid antibodies substantially reduce the risk of re-infection for a period of 6 months.Supplementary informationThe online version contains supplementary material available at 10.1007/s11845-022-02997-w.

Antibacterial Efficacy of Silver Nanoparticles Impregnated Calcium Hydroxide: An in Vitro Study

OBJECTIVE: To compare the in-vitro antibacterial effectiveness in terms of enterococcus faecalis elimination of conventional unmodified calcium hydroxide paste with an experimental calcium hydroxide impregnated with 1% silver nanoparticles. METHODOLOGY: This in vitro study was conducted during the period July 2019 - January 2020 at Materials Research Laboratory, Centralized Resource Laboratory (University of Peshawar) and Pathology Laboratory (Peshawar Medical College). Sixty human premolar teeth having single root with mature apices were obtained. These were distributed into two groups randomly (n=30); experimental group for testing the antibacterial efficacy of calcium hydroxide impregnated with 0.1% by weight silver nanoparticles and the other was used as a control group for testing the antibacterial efficacy of unmodified calcium hydroxide. Dentine specimens (size 4 x 4x 1mm) were prepared from the teeth using slow speed cutting saw machine. Smear layer was removed with EDTA. Specimens were autoclaved to sterilize them. Then each specimen was contaminated with enterococcus faecalis and incubated anaerobically for 24 hours at 37?C. After the application of medicaments, the zone of inhibition was measured and number of viable bacteria were determined using SEM. Statistical significance was calculated using t-test. p&lt;0.05 was taken as significant. RESULTS: After the application of medicament, the zone of inhibition was greater (9.63mm) in experimental group when compared to control group (4mm) (p&lt;0.001). Number of viable bacteria before application of medicament were 239 and 208 while after application of medicament reduced to 90 and 54 in control and experimental groups respectively (p&lt;0.001). CONCLUSION: The addition of silver nanoparticles to calcium hydroxide significantly enhanced its potential to eliminate biofilm of enterococcus faecalis on dentin specimens. KEYWORDS: Silver nanoparticles, Calcium hydroxide, Root canal infections, Root canal medicament.

Collagen Deposition Reduction by Vitamin E in Alcoholic Liver Injury

Background: Alcohol encourages fibrotic changes in liver by initiating collagen deposition in liver parenchyma. Vitamin E can slow down progress of fibrosis in alcoholic liver injury and play a defensive part against these changes. Aim To observe difference in fibrotic changes in livers of vitamin E treated and non-treated rabbits exposed to intra-gastric administration of alcohol. Study Design: Analytical experimental study Place and duration of study: Department of Anatomy, Peshawar Medical College, Peshawar Pakistan from 1st May 2019 to 30th October 2019. Methodology: Eighteen domestic type male rabbits (Oryctolaguscuniculus) were included. All animals were divided in two categories on the basis of experiment time frame. “Category E8” animals having 8 weeks’ time period and “Category E4” animals having 4 weeks experimental duration. Each category was then clustered in “Control Group A” (appropriate food as per standard laboratory requirements, and normal saline as drinking water was provided daily), “Experimental Group B” (proper standard nutrition, 30% solution of ethanol made in distal water in the dosage of 30ml per kg/day through nasogastric tube and normal saline for drinking purpose were provided daily) and “Experimental Group C” (treated with suitable standard required diet, 30% of ethanol solution made in distal water in the dosage of 30ml per kg/day via NG tube and “Vitamin E” 50mg dissolved in 2ml distal water per kg/day with same nasogastric tube daily and normal saline for drinking purpose were given). Results: Collagen fibers deposition (fibrosis) in liver stroma was detected and recorded according to Knodel histological activity index. Quantitative difference in the collagen deposition among all groups from both “Category E4” and “Category E8” presented vastly significant “P” values. Conclusion: Alcohol can cause major fibrotic changes in “liver” even if it is consumed for the minor duration of 4 to 8 weeks, and these alterations can be minimised by the proper use of vitamin e through its “antioxidant effect”. Keywords: Alcohol, Liver, Fibrosis, Vitamin E, Hepatocyte, Collagen

Design, Development &amp; Validation of an Assessment Tool for Undergraduate Medical Students of Community Health Sciences Rotation

Background: Questionnaires are the most commonly used data collection methods in applied research for assessment of inputs. It is a useful instrument if valid and reliable. Objectives; To establish, design and appraise the reliability and validity tool for measuring knowledge with skills among undergraduate students. Methods: An observational study conducted at Peshawar Medical College in six months’ duration through three stage process, after having approval of Institutional Review Board of Prime Foundation. Process initiated by slot regulation, component development and questionnaire generation with judgement analysis of instrument by an expert panel of five public health specialists for relevance, representativeness and transparency of each item based on Likert rating scale. Validity and reliability measured in the final steps. Suggestions put forward by the experts with item impact scores corresponded to face validity. Rewording, combination and elimination resulted in final 35 item instrument.Data was analysed through SPSS Version- 21 with computation of content validity ratio, content validity index, item content validity, scale validity, Kappa statistics and Cronbach’s Alpha values. Results: Mean years of experience for the panellists was 14.2 years with S. D + 5.2 (n= 5). Excellent CVR, I CVI, S CVI, Percent Agreement and Kappa statistics were calculated for the entire questionnaire as 1.The final 24 item knowledgesection had 0.732 Inter Class Correlation and acceptable Cronbach Alphaas 0.743, while the 11 item skill portion had 0.819 Inter Class Correlation with good Cronbach Alpha 0.890. Conclusions: The findings support the face and content validity of the questionnaire. Keywords: Instrument development and Validation, Competency, Knowledge, Skill, Assessment, Content Validity, Content Validity Ratio, Reliability, Questionnaire

Compare Bipolar Diathermy and Suture Ligation for Hemostasis in Tonsilectomy in Terms of the Amount of Blood Loss

Objective: The purpose of our study is to compare the outcomes in terms of blood loss, post-operative hemorrhage and operative time between bipolar diathermy and suture ligation for hemostasis in tonsillectomy. Study Design: Randomized Control trial Place and Duration: The study was conducted at ENT department of Peshawar Medical College Peshawar and Chaudhary Muhammad Akram Teaching and Research Hospital Lahore during the period from February 2020 to July 2020. Methods: There were ninety four patients of both genders with ages 5-40 years were presented. Included patients had chronic tonsillitis. After obtaining informed permission, the recruited patients' demographic data, including their age and gender, was recoded. Patients were equally categorized in two groups. Group I had 47 patients and received bipolar diathermy and group II received suture ligation among 47 cases. Outcomes among both groups were calculated and compared in terms of operative time, blood loss and post-operative complications. SPSS 25.0 version was used to analyze complete data. Results: Majority of the patients were males 55 (58.5%) and the rest were females 39 (41.5%) in study. In patients of bipolar diathermy mean age were 14.11±4.55 years while in group II mean age was 13.32±6.49 years. Number of left side tonsils in group I was among 25 (53.2%) patients and in group II left tonsils found in 30 (63.8%) cases. Mean operative time in group I was lower 11.9±8.88 minutes as compared to group II 15.4±4.35 minutes with p value &lt;0.03. Mean blood loss in group II was significantly higher 40.15±7.71 mL as compared to group I 25.4±6.42 mL with p value &lt;0.04. There was no any case found of post-operative hemorrhage in both groups. Frequency of ligatures among group I was 2 (4.3%) significantly lower than group II in 45 (95.7%) cases. Conclusion: We concluded in this study that the use of bipolar diathermy for hemostasis in tonsillectomy was beneficial and efficient in terms of less operative time with less blood loss as compared to suture ligation technique. Except this both technique are beneficial in term of post-operative hemorrhage which was not observed in both groups. Keywords: Bipolar Diathermy, Hemostasis Tonsillectomy, Suture Ligation, Hemorrhage, Blood Loss

A Comparison between Type-2 Diabetics and Non-Diabetics in Terms of Papillary Bleeding Index (PBI)

OBJECTIVES: The purpose of this study was to compare the Type 2 diabetes mellitus patients and non-diabetics in terms of Papillary bleeding index (PBI) of periodontal disease. METHODOLOGY: This comparative cross-sectional study was conducted during the period of November 2020 to February 2021 in three (3) tertiary care hospitals of Peshawar. The sampling technique was purposive sampling. The sample comprised 105 individuals, 56 participants in Type–2 diabetes group and 49 in non-diabetes group. Male and females, having age between 40-65 years were recruited. Each diabetic and non-diabetic were clinically examined for periodontitis. Age and sex-matched participants suffering from periodontitis without a history of diabetes as well as with good glycemic control (HbA1c) were considered as controls subjects. Glycated hemoglobulin (HbA1c) was carried out for all the participants free of cost by using Human Gmbh-Max-Planck-Ring 21-65205 Wiesbaden-Germany kit. The study was approved by the ethical committee of the Peshawar Medical College. Data was analyzed using software package SPSS version 20. RESULTS: Out of 56 diabetics, 24 subjects brushed once daily, 15 brushed twice daily, 11 brushed occasionally and 6 didn’t brush whereas in 49 non diabetics, 20 subjects brushed once daily, 13 brushed twice daily, 11 brushed occasionally and 5 didn’t brush. The clinical parameter mean (PBI) was recorded in our study. Score was 2.09 (±0.82) in diabetics and 1.02 (±0.47) in non-diabetics. P-value measured by the chi square test was significant. Spearman correlation test was performed to explore the association between the type 2 diabetes and Papillary bleeding index (PBI). CONCLUSION: We concluded that a significant difference exists between the mean PBI scores of Type 2 diabetics and non-diabetics.

Light Microscopic Study on Possible Protective Effect of Vitamin E on Imatinib IHCV Dilatation in Albino Rats

Aim: To observe the changes in the caliber of hepatic central vein of Albino rats exposed to the oral administration of toxic doses of Imatinib and to assess the protective effect of vitamin E. Study design: Experimental study Place and duration of study: Department of Pharmacy, Peshawar Medical College Peshawar from 1st October 2015 to 31st March 2016. Methodology: Twenty four male Sprague-Dawley rats (150- 200g) were selected for this study and these rats were divided into three groups. Group 1 was control group, Group II received oral Imatinib solution (50 mg/kg/day) and Group III received Imatinib solution (50mg/kg/day) orally along with vitamin- E (500MG/kg/day) for 14 days. At the end of experiment central vein dilatation in liver tissue of rats were observed. Results: The increase in mean central vein dilatation in liver of group II were statistically significant (p=0.001) in comparison with the control. The mean central vein caliber of liver was decreased significantly in group III. Conclusion: The simultaneous use of vitamin E as an antioxidant with Imatinib can protect the toxic effects of the Imatinib on hepatic toxicity which includes central vein dilatation. Keywords: Imatinib mesylate, Hepatic tissue, Central vein dilatation, Vitamin E

Detection of Epstein Barr Virus (EBV) Antigen in Oral Squamous Cell Carcinoma (OSCC) by Immunohistochemistry in Patients from KPK Province of Pakistan.

Objective: To determine the frequency of EBVLMP-1 antigen positivity in OSCC and normal oral squamous epithelial tissues (control) by immunohistochemistry (IHC) and to see the effect of age and gender in both the OSCC and control tissues. Study Design: Descriptive, Cross Sectional, Multicenter study. Setting: Pathology/ Peshawar Medical College (PMC), Peshawar Dental College and Sardar Begum Dental College, Peshawar. Period: April 2018 to September 2018. Material &amp; Methods: Conducted on total 60 samples divided into two groups. Group A: 30 formalin fixed paraffin embedded tissue blocks of OSCC cases and Group B: 30 non neoplastic oral epithelial tissues (control). Both groups A and B slides were stained through immunohistochemistry for EBV LMP-1 monoclonal antigen. Results: 30 cases of OSCC Group A and 30 cases of non-neoplastic oral mucosa Group B were selected for the LMP-1 staining by immunohistochemistry. The mean age of OSCC was 56.5 years (±14.47 Standard deviation) with a range of 20-80 years. Male: Female ratio was 1.3:1 .OSCC commonly involved buccal mucosa. 80% (n=24/30) OSCC cases were grade 1, all the cases of OSCC (100%) showed epithelial positivity for EBV LMP-1 antigen, whole (29/30) cases of non-neoplastic oral mucosa cases showed positivity and there is no statistically significant difference in both Groups A and B. Conclusion: With the findings of EBV positivity in both the OSCC and all of the control cases; it is concluded that EBV does not play an important role in etiology of OSCC. This suggests that the infection by this ubiquitous virus (EBV) occurs at some point in the life of a person leaving LMP, protein latent in the cells of oral epithelium.

Counter effects of Vitamin E against Outcomes of Alcohol Toxicity in Pancreatic Acini: Histomorphometric Study

Aim: To evaluate the effects of alcohol on the microscopic morphology of the exocrine pancreas and blood serum amylase and to explored that if vitamin E has a protective role against alcohol-induced damage in the pancreas of rabbits. Study design: Analytical experimental study Place and duration of study: Departments of Anatomy, Pathology and Pharmacology in Peshawar Medical College Pakistan from 1st January 2019 to 30th June 2019. Methodology: Eighteen healthy adult male domestic rabbits weighing 1-1.5 kg were chosen (oryctolaguscuniculus). The control group A received proper food and normal saline as drinking water, experimental group B received proper diet and 30 percent ethanol solution (30ml/kg/day) orally daily with normal saline, and experimental group C received proper diet, 30 percent ethanol solution (30ml/kg/day), vitamin E (50mg/kg/day) orally daily with normal saline. Each rabbit's blood was taken for serum amylase. Morphology of acinar cells included: 1) number of cells, (10 acini/field, 2) size of acini, 3) size of acinar cells, and 4) size of acinar nuclei. Results: Normal value of serum amylase in rabbits was found. The difference in serum amylase levels between the control and experimental groups for both E4 and E8 animals was not statistically significant. There was no significant difference in the number of pancreatic acinar cells, size of pancreatic acini, the pancreatic acinar cell size, and pancreatic acinar cells nuclear size in the control and experimental groups for both E4 and E8 animals. Conclusion: Alcohol consumption had no influence on the histomorphology of the rabbits' pancreatic acini in a short period (4-8 weeks). No significant variation was noted in the pancreatic acinar cells count &amp; size, pancreatic acinar cells nuclear count and size, and pancreatic acini size. Therefore, protective role of vitamin E was not usefully identified. Keywords: Alcohol, Pancreas, Histomorphology, Vitamin E, Serum amylase

Hepatocytes Protection by Vitamin E in Alcoholic Liver Injury: A Light Microscopic Study

Background: Alcohol induces histomorphological changes in the liver and vitamin E has a protective role against these changes. Objective: To observe changes in hepatocytes of rabbits exposed to intragastric administration of alcohol and the protective role of vitamin E against these changes. Study Design: Analytical experimental study Place and Duration of Study: Department of Anatomy, Pathology and Pharmacology of Peshawar Medical College, Peshawar, Pakistan from 1st January 2016 to 30th June 2016. Methodology: Eighteen male rabbits domestic type (Oryctolaguscuniculus) were included. Experimental duration for category E8 animals was 8 weeks while for category E4 animals it was 4 weeks. The groups were, control group A in which animals were given proper food and normal saline as drinking water, experimental group B in which animals were fed on proper diet and 30% ethanol solution (30 ml/kg/day) orally daily with normal saline and experimental group C in which animals were treated with proper diet, 30% ethanol solution (30 ml/kg/day), vitamin E (50 mg/kg/day) orally daily and normal saline as drinking water. Results: The difference in the ALT, hepatocyte count and size and hepatocyte nuclear count and size of control and experimental groups and experimental group B-II and C-II from both category E4 and E8 showed a highly significant P values. Conclusion: Alcohol causes histomorphological changes in the liver even in the short period of 4-8 weeks and these changes can be minimized by the antioxidant action of vitamin E. Keywords: Alcohol, Liver, Histomorphology, Vitamin E, Hepatocyte, ALT

Histopathological Typing and Topographic Distribution of Head and Neck Lesions: An Eight Year Retrospective Study

Objective: To analyze the histopathological pattern of head and neck lesions with respect to demographic findings referred to the histopathology lab of Peshawar Medical College (PMC).&#x0D; Study Design: Descriptive cross-sectional study.&#x0D; Place and Study duration: Histopathology laboratory of PMC, Peshawar, Pakistan. Jan 2010 to Dec 2018.&#x0D; Materials and Methods: A retrospective study was conducted on a total of 743 specimens submitted to the histopathology lab for diagnosis. Variables like age, gender, site, and histopathological spectrum were evaluated. Statistical Package for Social Sciences (SPSS) version 19 was used for descriptive and inferential statistics considering p-value ≤0.05 significant.&#x0D; Results: In our study &lt;30 age group was common for head and neck lesions. Females were frequently affected than males. A maximum number of diagnosed lesions was benign in nature with goiter as the most common lesion. Oral squamous cell carcinoma (OSCC) was a widespread malignant neoplasm. According to the site, the thyroid showed 36%of lesions followed by 9.5% lip and oral cavity and lymph nodes respectively.&#x0D; Conclusion: This study concluded a variety of head and neck lesions with respect to age, gender, and site in our region that can help in improved understanding, management, and control of the disease.

Frequency Distribution of Hepatitis C Virus Genotypes with Reference to Age and Sex in Various Districts of Khyber Pakhtunkhwa, Pakistan

Background: Pakistan has the second highest prevalence of hepatitis C in the world after Egypt. Viral hepatitis is a leading cause of morbidity and mortality in Pakistan and, worryingly, reinfection rates are also on the rise. This cross-sectional study was aimed at finding the most common genotypes of hepatitis C in terms of age and sex in a Pakistani cohort. Materials and methods: The authors collected blood samples from 1,260 patients with diagnosed hepatitis C visiting a primary teaching hospital affiliated with Peshawar Medical College, Pakistan, from different districts of Khyber Pakhtunkhwa, Pakistan, between January 2017 and April 2019. Hepatitis C virus RNA was quantified by real-time polymerase chain reaction and genotyping was then performed. Results: The authors found that genotype 3a was the most prevalent type followed by 1a, mixed, and 3b, respectively. Genotypes 2a and 1b were the least prevalent in Khyber Pakhtunkhwa. The most common genotype was 3a, observed in 75.87% of cases. The most common mixed genotype was 3a+1a, observed in 39 cases (3.10%); it had a prevalence of 3.49% in females compared with 2.70% in males. Overall, the most common age group affected by hepatitis C virus was 41–50 years (31.35%), followed by the 51–60 years group (24.45%). Infection rate was comparatively low in other age groups. A significant difference was observed in the prevalence of genotype 3a and 2a among different districts. Conclusion: The authors concluded that genotype 3a was the most prevalent genotype and it was observed more frequently in the female population, with a median age of 45 years.

EXFOLIATIVE CYTOLOGICAL FINDINGS IN ORAL POTENTIALLY MALIGNANT DISORDERSMALIGNANT DISORDERS

Objective: Patients with oral potentially malignant disorders (OPMDs) are at risk for development of malignancy and tobacco use contributes in its transformation. This study was designed to assess exfoliative cytological findings in OPMD cases using tobacco and healthy controls with no history of tobacco use. The aim was to screen OPMD cases for biopsy with the help of brush cytology.&#x0D; Materials and Methods: This comparative cross-sectional study was conducted at Histopathology Laboratory of Peshawar Medical College, Peshawar for which samples were collected from two dental hospitals and private dental clinics of Peshawar. The study included 20 cases of clinically diagnosed Oral Potentially Malignant Disorders (OPMDs) with history of tobacco use; including 10 cases of leukoplakia and 10 cases of oral lichen planus (OLP), and 20 age and gender matched healthy controls with no history of tobacco use, after observing a strict inclusion and exclusion criteria. A pre-designed proforma was used to collect the data, which was later analyzed in SPSS version 21.&#x0D; Results: A total of 40 participants had a mean age of 48.25±10.01 years with gender distribution of 32(80%) males and 8(20%) females, giving a male to female ratio of 4:1. The duration of tobacco use in cases had a mean of 22.95 ± 9.17 years, while duration of lesion had a mean of 2.3±4.4 years. As per Oral Bethesda Criteria, 18 (90%) OPMD cases were Negative for Intraepithelial Lesion/Malignancy (NILM). Buccal mucosa 12(60%) was the most common site of lesions. On Oral Exfoliative Cytology (OEC), OPMDs showed mild to moderate cytological changes as compared to healthy controls.&#x0D; Conclusion: This study concluded that most of the OPMD cases show mild to moderate cytological changes as compared to healthy controls. Dysplastic changes were seen only in 10% of OPMD cases that needed further assessment through biopsy.