BACKGROUND: A large number of infectious diseases are transmitted primarily through the water supplies contaminated with human and animal excreta. This study was undertaken for the microbiological testing of bottled water used for drinking purposes by the public in the Lahore city.

METHODS: This descriptive study was undertaken for the microbiological testing of bottled water used for drinking purposes by the public in the Lahore city.

RESULTS: Twenty-four samples were collected at investigator’s convenience.  Microbiological testing was performed using the membrane filter technique. Of the 24 samples tested, two (8.3%) were found to be contaminated with bacteria found in human or animal excreta.

CONCLUSION: Although only 8.3% samples were found to be unsafe bacteriologically, this emphasizes that all bottled waters should not be taken for granted to be safe for consumption and may need to undergo additional processing by the consumers.

Unicystic ameloblastoma is a rare, benign tumor of odontogenic epithelium. We report a case of unicystic ameloblastoma in a 29-year-old female with pain and swelling in the posterior left mandibular region. Fine needle aspiration yielded no fluid. Periapical, panoramic and computer tomography scans showed well-defined radiolucency in relation to left mandibular first and second molars. Unicystic refers to those cystic lesions that show clinical, radiographic, or gross features of a cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. Enucleation and tumor resection were performed for the treatment.

Lymphatic filariasis (LF), a mosquito vector-borne disease, is a major public health problem in many parts of the tropics. It is considered eradicable or potentially eradicable by the International Task Force for Disease Eradication. India contributes about 40% of the total global burden. Extranodal filariasis is a rare entity and breast is an uncommon site for filariasis with only a few cases reported in the literature. The demonstration of parasite in aspirate plays a significant role in recognition of disease and institution of specific treatment. Fine needle aspiration cytology can be regarded as a safe and reliable initial step, which can provide the pathologists as well as the clinicians a definitive diagnosis within a short period of time.

 BACKGROUND: The purpose of this study was to investigate the demographic profile, risk factors, angiographic findings and treatment recommendations in patients with coronary artery disease (CAD).

METHODS: This descriptive study was carried out at the Department of Cardiology, Lady Reading Hospital Peshawar. Clinical and risk factors data was collected by clinical evaluation and reviewing hospital record. Angiographic data was collected by analyzing angiograms. Data was analyzed using Statistical Package for Social Science (SPSS) version 19.

 RESULTS: A total of 1325 patients were included in the study out of which 980 (73.80%) were male. Their mean age ±SD was 53±10.8years. Thirty six (36%) patients suffered from hypertension, 17% had diabetes mellitus, 42% had dyslipidemia, 37% were smokers and 32% had history for premature coronary artery disease. On angiographic analysis 251(18.9%) patients had single vessel disease (SVD), 344(26%) had double vessel disease (DVD), 596(45%) had triple vessel disease (TVD), 42(3.2%) had left main disease (LMD) and 92(6.9%) had normal coronary arteries. The involvement of left anterior descending (LAD), circumflex and right coronary artery (RCA) was 42%, 26% and 32% respectively. A total of 2517 lesions were identified in which mild, moderate and severe were 276(11%), 327(13%) and 1912(76%) respectively. American Heart Association (AHA) type A, B and C lesions were 931(37%), 1283(51%) and 302(12%) respectively.  Mean±SD lesion length was 5.9±3.8 mm. Others characteristics of lesions included ostial stenosis in 118 (4.7%), bifurcation stenosis 528 (21%), calcification 191(7.6%) and chronic total occlusion 151 (6%). Percutaneous coronary intervention (PCI) and coronary artery bypass surgery (CABG) was advised in 874(66%) and 251(18.9%), respectively.

CONCLUSION: Conventional risk factors were highly prevalent in our patients with coronary artery disease. Double and triple vessels disease was most common in our patients and PCI was frequently used as treatment modality.

 BACKGROUND: Ovarian cancer is the fifth most common cancer among women and it causes more deaths than any other type of female reproductive cancer. In the United States, approximately 22,430 new cases of ovarian cancer are diagnosed annually. Ovarian cancer is a cancerous growth arising from the ovary. Infertile women and those with a condition called endometriosis, those who have never been pregnant and those who use postmenopausal estrogen replacement therapy are at increased risk. Among the causes of cancers, epigenetic change like hypermethylation of tumor suppressor genes has been one of the main routes for the development of cancer. The aim of this study was to identify promoter hypermethylation in CpG islands of RASSF1A gene in ovarian cancer patients among the Kashmiri population.

 METHODS: This was a hospital-based case-control study. We analyzed the methylation status of CpG islands in the RASSF1A gene in histopathologically confirmed ovarian cancer samples and histopathologically normal ovarian tissues using methylation specific polymerase chain reaction (MS-PCR). Chi square test with odds ratio was used to ascertain whether the results were statistically significant and a p-value <0.01 was considered statistically significant.

 RESULTS: Subjects with histopathologically confirmed ovarian carcinoma (50 cases) and histopathologically confirmed normal ovaries (20 controls) were evaluated. The epigenetic analysis of the cases and controls revealed that the Kashmiri population has a different hypermethylation profile of RASSF1A gene promoter. We found that 66% of the cases had RASSF1A promoter hypermethylation as compared to normal controls in which only 10% were hypermethylated. The association of promoter hypermethylation with ovarian cancer was statistically significant (OR=17.47, 95% CI=3.62-84.32, p=0.0001).

 CONCLUSION: The RASSF1A gene promoter is often methylated in ovarian cancer patients of Kashmiri origin. The hypermethylation of RASSF1A may be one of the mechanisms that derive uninterrupted cell division and growth, a hallmark of malignant cells. Whether growth rate of cancer cells is decreased by modulating RASSF1A gene expression with demethylating agents and DNA methylation inhibitors needs further study.

We present a case of a 25-year-old primigravida with intrauterine death of fetus secondary to umbilical cord stricture at 31 weeks of gestation. She presented with a 1-day history of disappearance of fetal movements and a subsequent diagnosis of intrauterine death was made on ultrasonography. A well-defined site of stricture and torsion was present at the fetal end of the umbilical cord, distal to which the umbilical cord was dilated and ecchymotic. Literature suggests the absence of Wharton’s jelly as a probable etiology of umbilical cord stricture. This stricture can lead to acute obstruction of the fetal-placental circulation. Umbilical cord stricture is not detected on ultrasonography, which can result in unpredictable and unpreventable intrauterine death of the fetus.

BACKGROUND: Serological tests have not been validated in the diagnosis of Hirschsprung’s disease. The aim of the present study was to evaluate the role of erythrocyte acetylcholinesterase in the diagnosis of Hirschsprung’s disease.

METHODS: This study was a prospective study conducted on 30 patients clinically suspected to have Hirschsprung’s disease who were admitted in a tertiary care referral center in Srinagar, India. All patients had erythrocyte acetylcholinesterase measured and underwent a full thickness rectal biopsy.

RESULTS: In our study, the mean (+ standard deviation) age at presentation was 3.51 + 0.4 years. Most patients were males (76.7%). Rectal biopsy was considered as the gold standard for the diagnosis of Hirschsprung’s disease with absent ganglion cells in 22 (73.3%) and absent ganglion cells with nerve hypertrophy in other 4 (13.3%) patients. Preoperative erythrocyte acetylcholinesterase had a diagnostic accuracy of 66.7% and a sensitivity of 84.6% with a specificity of 75%, positive predictive value (PPV) of 95.6% and negative predictive value (NPV) of 42.9%. Mean postoperative acetylcholinesterase levels were 11.5 KU/L, significantly lower than the mean preoperative levels of 17.6 KU/L (p < 0.05).

CONCLUSION: Erythrocyte acetylcholinesterase can be used as an initial screening test in clinically suspected cases of Hirschsprung’s disease due to its high sensitivity. It confers an additional advantage in that it is comparatively non-invasive and does not require any preparation.

Chondrosarcoma is an uncommon malignant mesenchymal tumor of the head, neck, oral and maxillofacial regions characterized by the production of cartilaginous tissue and the absence of production of bone tissue. Mandibular localization of these tumors is rare. These tumors grow indolently to large sizes in young males. These neoplasms reveal aggressive local behavior and a high metastatic potential. Wide surgical excision is one of the preferred treatments, although radiotherapy and chemotherapy are advised as an adjunct without many advantages. We report a case of mesenchymal chondrosarcoma of the mandible in a young female that exhibited massive extension of the tumor to the soft tissues.

Epidemiological studies have been inconsistent in finding a protective association of green tea with risk of different cancers. We conducted an extensive literature review to assess the current evidence examining the association of green tea consumption with different types of cancers. In several studies, high intake of green tea was associated with reduced risk of gastrointestinal cancers. The small number of studies that examined the association of green tea consumption on lung, kidney and bladder cancer also found a protective association. Further human studies are needed to establish the role of green tea as an anti-cancer agent.