Chandka Medical College

About: Chandka Medical College is a education organization based out in Larkana, Pakistan. It is known for research contribution in the topics: Population & Outpatient clinic. The organization has 106 authors who have published 108 publications receiving 1170 citations.

Incidence of xeroderma pigmentosum in Larkana, Pakistan: a 7-year study.

Abstract: Xeroderma pigmentosum (XP) is a rare autosomal recessive inherited disorder caused by a defect in the normal repair of DNA of various cutaneous cell types damaged by exposure to ultraviolet radiation We present our 7-year experience with 36 XP patients who either visited the Department of Dermatology or were seen in the medical camps arranged in remote areas for patients' welfare, from 1995 to 2001 For ease of discussion we classified all cases into the following subgroups on clinical grounds only: mild, those with light brown freckles on the face alone; moderate, those with dark brown freckles with burning on the face, neck, ears, chest, hands and photophobia but without other associated obvious cutaneous and ocular changes; severe, those with extensive dark brown freckles with burning on the exposed parts as well as on the unexposed parts of the body, ie the chest, back, abdomen and arms including other associated cutaneous and ocular changes such as ulcers and malignancy Of 36 patients, three (83%) were classified as mild, nine (25%) moderate and 24 (667%) severe; there were 18 males and 18 females, age range 2-30 years (mean 89 years) Seventeen patients had cutaneous changes: actinic keratosis, keratoacanthoma, fissures and ulcerative nodules on the exposed parts of the body Four patients had wide ulcers, along with mass formation and severe pigmentation on the face, neck and head Twenty-nine patients developed ocular symptoms: photophobia, conjunctivitis, corneal keratitis and lid ulcer One patient had complete loss of vision Histopathological findings revealed that six patients had squamous cell carcinoma (SCC) on the face, head, ear or lip More than one sibling (two to four) was affected in four families The majority of cases (20/36, 556%) were from the Brohi tribe (skin type III), while the remaining cases (16/36, 444%) were from the Sindhi population (skin type IV) The large number of XP patients seen in those with skin type III (Brohi tribe) compared with skin type IV (Sindhi population) indicates that the skin type and the race has a considerable value in the pathogenesis of XP Furthermore, 24 of 36 patients were in the severe group and six of these had SCC Moreover, no neurological abnormalities were observed in our patients All patients were treated according to disease severity by prescribing oral antibiotics, local steroids, sunscreens and/or chemotherapy followed by irradiation in malignant cases Two patients died because of extensive SCC

Brain abscess--diagnosis and management.

Abstract: Objective To evaluate the clinical presentation, diagnosis, sources of infection, surgical management outcome and microorganisms involved in the brain abscess in our locality. Design Descriptive study. Place and duration of study The department of Neurosurgery, Chandka Medical College Hospital, Larkana from July 1998 to June 2003. Subjects and methods All patients who were confirmed cases of brain abscess were entered into the study. Data collected on proforma, contained categories of age, gender, clinical presentation, diagnostic laboratory findings, computed tomography scan reports, associated anomalies, surgical management, culture reports antibiotic therapy, microbiologic features and treatment out come. Results Out of 82 patients, 58 were males and 24 females. Mean age was 18 years (range 05 months to 55 years). Headache with papilloedema was the commonest presentation (82%). Neurological deficit was present in 46%. A source of infection was present in 89%. Otogenic source was the commonest (63%). CT scan was diagnostic in all (100%) cases. Solitary abscess was found in 79% of the cases while in 21% of the cases multiple abscess were found. Temporal lobe was the commonest site involved (55%). Cultures were found positive for microorganism in 82% of the cases. Bacteriodes (38%) and Streptococci (25%) were the commonest isolates. Burr hole aspiration was done in only 38% of the cases while excision of the capsule along with aspiration was carried out in 62% of the cases. Over all morality was 22% in this series; causes of death were septicemia, ventriculitis and pneumonia. Conclusion Diagnosis with CT scan, appropriate antibiotic therapy and complete removal of abscess along with excision of capsule could reduce the mortality and neurological deficits from brain abscess.

Polymorphisms of cytochrome b gene in Leishmania parasites and their relation to types of cutaneous leishmaniasis lesions in Pakistan.

Abstract: The exact species and/or strains of Leishmania parasites involved strongly influence the clinical and epidemiological features of leishmaniasis, and current knowledge of those influences and relationships is inadequate. We report that cytochrome b (cyt b) gene sequencing identified causal Leishmania parasites of 69 cutaneous leishmaniasis cases in Pakistan over a 3-year period. Of 21 cases in highland areas (Quetta city, Balochistan province), 16 (76.2%) were identified as Leishmania (L.) tropica and five (23.8%) as Leishmania (L.) major. Of 48 cases from lowland areas, cities/villages in Indus valley in Sindh and Balochistan provinces, 47 (97.9%) were identified as L. (L.) major and one (2.1%) as L. (L.) tropica. Statistical analysis (Fisher's exact test) revealed a significant difference (P < 0.0001) in the distribution of the two species by altitude; L. (L.) major is predominant in lowland and L. (L.) tropica at highland areas. The present result enriched our earlier finding, based on the first year's cultured parasite data, that only L. (L.) tropica was found in highland areas and only L. (L.) major in lowland areas. Among Leishmania samples analyzed, three types of cyt b polymorphism of L. (L.) major were found, including 45 (86.5%) cases of type I, six (11.5%) of type II and one (2%) of type III. We report for the first time on the presence of polymorphisms in L. (L.) major (types I, II and III) based on species identification using cyt b gene sequencing from clinical samples. Moreover, we found no correlation between clinical presentation (wet-, dry- and/or mixed-types of cutaneous lesions) and causal Leishmania parasites.

Effects of nigella sativa on various parameters in Patients of non-alcoholic fatty liver disease.

Abstract: Background: Non-alcoholic Fatty Liver disease (NAFLD) is the most common cause of progressive liver disorders worldwide. Drug options are limited with varying results. Nigella sativa in the form of herbal medicine could be another option because of its strong historical background. The objective of the study was to evaluate the effect Nigella sativa on various parameters in patients of NAFLD. Methods: A randomized controlled trial was conducted at outpatient clinic of medical unit-1 of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, in which seventy patients of NAFLD were divided in to interventional and non-interventional groups. The interventional group was given cap Nigella sativa 1g twice a day while non-interventional group was given cap placebo in a same way for three months. Body weight, BMI, liver enzymes and ultrasound finding of fatty liver were assayed before and after treatment. Results: After 12 weeks treatment with Nigella sativa body weight decreased significantly from 86±13.8 to76±12.6 kg vs placebo ( p =0.041). BMI also reduced significantly from 29.06±4.6 to 26.25±6.2kg/m 2 vs placebo( p =0.012). There is remarkable reduction in aminotransferases level after treatment with Nigella sativa vs placebo (ALT: 78.05±5.52 to 52.6±5.65 IU/L vs 76.48±4.95–74.32±5.58 IU/L ( p =0.036). AST: 65.54±4.56–44.56±5.52 IU/L vs 63.25±5.43–59.43±3.39 IU/L ( p =0.021). There was overall 57.14 % patient had normal fatty liver grading on ultrasound after 12 weeks treatment with Nigella sativa as compared to placebo ( p =0.002). Conclusion: Nigella sativa improves bio chemical and fatty liver changes in NAFLD patients. Its use in early stages of NAFLD is recommended in order to prevent its life-threatening complication. Keywords: NAFLD; Nigella sativa ; Body weight; ALT; AST; Fatty liver grading