Author Archives: admin

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

OA_Variation in Attitude towards Oral Healthcare Among Undergraduate Students of A Private Medical & Dental College of Karachi

Uzma Zareef*, Imran Bakar**, Samia Khanam***, Arif Ali****, Shamsul ArfinQasmi***** and

Muhammad Adnan Kanpurwala******

*Dept. of Oral Pathology Liaquat College of Medicine and Dentistry, ** Dept. of Pathology, Hamdard College of Medicine and Dentistry, *** Dept. of Pathology, Altamash Institute of Dental Medicine **** Dept. Of Statistics, Dow University of Health Sciences, **** Dept. of Pathology, Karachi Institute of Medical Sciences (KIMS), ******Dept. of Physiology, Karachi Institute of Medical Sciences

Undergraduate Forensic Medicine & Toxicology Curriculum_ Current Practices and Recommendations for the Future

Rizwan Zafar Ansari*, Muhammad Yousaf**and Farooq Ahmed Abro***, ZahidHussain Khalil****

*Department of Forensic Medicine, Northwest School of Medicine, Peshawar, ****Professor & Supervisor Department of Forensic Medicine, Kabir Medical College, Peshawar **Department of Forensic Medicine, Khyber Medical College, Peshawar,***Department of Forensic Medicine, Frontier Medical & Dental College, Abbottabad,

Editorial: Integrated Examinations in 4th& 5thYear of MBBS

Anwar UlHaque

Department of Pathology, Northwest School of Medicine,Peshawar, Pakistan

Integrated modular examinations in Medical Colleges had gained worldwide acceptance due to its obvious advantages. However it has been observed that some medical colleges are not conducting integrated examinations in their 4th and final years. One fails to understand why it is not done. Of course taking traditional style annual examination is far easy and more convenient to the busy physicians but does it extracts from the candidates what it must. I mean the holistic and all multidimensional comprehension of the subject.

Original Article: Short-Term Clinical Outcomes of Drug Eluting Stents in Diabetic versus Non-Diabetic Patients Having Stable Coronary Artery Disease

Yasir Adnan*, Lubna Noor**, Muhammad Habeel Dar**,Haris Adnan*** and

Muhammad Hafizullah**

*Department of cardiology, Police and Services Hospital, Peshawar, **Department of Cardiology,

Lady Reading Hospital, Peshawar and *** Category C Hospital, Nahaqi Peshawar



Background: Diabetes mellitus (DM) increases the risk of adverse outcomes after coronary artery revascularization. Diabetic patients have a worse prognosis than non-diabetic patients, with generally greater rates of death, myocardial infarction and need for target lesion and vessel revascularization.

Objectives: The aim of this study was to assess the Short-Term clinical outcomes in diabetic versus non-diabetic patients who underwent successful percutaneous revascularization with drug-eluting stents.

Material and Methods: Between April 2011 and July 2012, 144 diabetic and 232 non-diabetic patients with stable coronary disease undergoing DES implantation at Cardiology Unit Lady Reading Hospital, were enrolled prospectively. Clinical outcomes (Myocardial infarction [MI], unstable angina [UA], and positive ETT) at three months were measured in Diabetic and non-Diabetic patients who received DES for coronary artery lesions. All patients were followed and reassessed after 3 months from the index procedure. Exercise Tolerance Test (ETT) was performed on every patient and recorded on Proforma. Data analysis was done using SPSS version 16.

Results: We evaluated 376 patients with stable coronary artery disease treated with DES of the 376 patients, 144 (38.3%) were Diabetics. The mean age was57±9.313 years. Male patients were 271(72.1%). At 3-Months follow-up, diabetic patients treated with DES had significantly higher rates for myocardial infarction (5.6 vs. 1.3%; p = 0.025), unstable angina (12.5 vs. 3.4%; p = 0.001) and positive ETT (16.7 vs. 5.6%; p = 0.001).

Conclusion: Our study revealed that despite the use of DES the risk of myocardial infarction, unstable angina, and positive ETT at three months remains higher in diabetic patients.

Key Words: Coronary Artery Disease, Drug Eluting stent, Exercise tolerance test.

Original Article: Lymphoma Distribution Trends from Single Institute of Pakistan: Spectrum of 212 Cases

Durr-e-Sameen Kamran*, Hira Salam**, Uzma Bukhari* and Shaheen Sharafat***

*Department of Pathology, **Department of Oral Pathology, ***Basic Medical Sciences, DIMT,

Dow Diagnostic, Research & Reference Laboratory. Dow University of Health Sciences, Ojha Campus,

Karachi, Pakistan



Objective: Lymphoid neoplasms encompass an enormous group with diverse subtypes. The incidence is contrastingly diminished in developing countries. Pakistan lacks a national cancer registry for exact characterization of statistics. The objective of this study was to draw histopathological spectrum of lymphoma subtypes diagnosed and characterized at Histopathology section of Dow University of Health Sciences, Karachi.

Methods: Every lymphoma case diagnosed at Dow Diagnostic Reference and Research Lab and Dow University of Health Sciences Karachi during study period (January 2014 – December 2015) was included without exception. Pertinent clinicopathological information was entered in a proforma. Paraffin-embedded tissue blocked were retrieved from histopathology archives and cross-examined. Data was analyzed using SPSS 16.0.

Results: Out of 212 lymphoma cases, 79% were of Non-Hodgkin Lymphoma (NHL) and 21% were of Hodgkin Lymphoma (HL). Diffuse Large B-cell Lymphoma (DLBCL) was the prevalent subtype. Nodular Sclerosis (NS) dominated the HL class. Mean age at onset was significantly higher for NHL (p<0.01). Male to female ratio was 1.7:1. Cervical lymph nodes are most frequently involved site for primary nodal lymphomas, whereas GIT is predominantly involved by extra-nodal group.

Conclusion: Lymphomas render a considerable measure of morbidity and mortality globally. Due to pronounced heterogeneity in divergent subtypes, their prevalence also varies and hinders understanding of etiologic factors. Epidemiologic studies are paramount for improving our understanding and subsequent delivery of healthcare. We have described the spectrum of lymphoma as registered in one hospital in Pakistan. More studies from developing countries on broader scale are imperative for streamlining future research goals.

Original Article: Validity of Mean Platelet Volume to Detect Hyperdestructive & Hypoproductive Thrombocytopenia in Tertiary Care Setting

Wardah Aslam1, Maryam Habib2, Mobina Ahsan Dodhy3, Masooma Shaheen4 and Madiha Habib5

*Department Of Pathology, Noori Hospital Islamabad, **Faculty Of Pathology Shifa College Of Medicine, ***Faculty Of Pathology, Khawaja Muhammad Safdar Medical College Sialkot, ****Department Of Pathology, District Headquarter Attock, *****Faculty Of Dentistry, University Of Malaya, Malaysia



Objective: Determine the validity of mean platelet volume (MPV) to detect hyper-destructive & hypo-productive thrombocytopenia, keeping bone marrow aspiration and biopsy as gold standard.

Study Design: Cross sectional (Validation) study.

Material and Methods: A total number of 147 patients of thrombocytopenia were enrolled.CBC of the patient was done using an EDTA sample. Bone marrow aspiration and biopsy was also performed. Keeping aspiration results as gold standard specificity and sensitivity of MPV was validated in diagnosing the type of thrombocytopenia.

Results: Mean platelet volume has a Sensitivity 95%, Specificity 15.7%, Positive Predictive Value64%, Negative Predictive Value 69.2% in detecting Hyper-destructive thrombocytopenia. It has a Sensitivity of 15.7%, Specificity 95.5% with a Positive Predictive Value of 69%and Negative Predictive Value of 64% in detecting Hypo-productive thrombocytopenia.

Conclusion: Mean platelet volume has limited sensitivity and specificity and can be used as an initial indicator but bone marrow aspiration and biopsy remains the gold standard for distinguishing between hyper-destructive and hypo-productive thrombocytopenia.

Keywords: Thrombocytopenia, hyper-destructive & hypo-productive thrombocytopenia, Mean platelet volume

Original Article: Histopathological Evaluation of Excessive Uterine Bleeding of Reproductive Age Group in Hysterectomy Specimens

Shabana Naz, Ehtisham Ahmed Khan Afridi, Shagufta Naeem and Raisa Naz

Department of Pathology, Ayub Medical College Abbottabad



Objective: Determine the frequencies of uterine pathologies in women of reproductive age group presenting with excessive uterine bleeding.

Material and Methods: This study was conducted in the histopathology section of the Department of Pathology at Ayub Medical College Abbottabad. This was a descriptive study of 100 hysterectomy specimens removed for excessive uterine bleeding received in the department over a period of six months. All the specimens belonging to patients of reproductive age group (30-50 years) with excessive uterine bleeding were included in this study. The data recorded from the specimen request forms included the patients’ clinical presentation, reproductive history and history of hormone intake.  All the specimens were received in ten-percent formalin and were examined grossly. Multiple sections 3-5 microns thick were taken, stained with haematoxylin and eosin and examined under Olympus Microscope CX23.

Result: The most common uterine lesions associated with excessive uterine bleeding were leiomyoma (43%) and adenomyosis (24%).

Conclusion: As leiomyoma is the most common lesion found in the uterus of the patients in which hysterectomy is done for excessive uterine bleeding; this is a treatable cause. As most females are in child bearing age so female of child bearing age should be investigated thoroughly before considering hysterectomy.

Key words: Hysterectomy, excessive uterine bleeding, leiomyoma, adenomyosis